title: An association study of disease activity score components and patient satisfaction with overall health for early RA patients on non-biologic DMARD therapy.
abstract: Patient overall satisfaction with health (PSH) was measured by a subset of questions from the Arthritis Impact Measurement Scales II. Based on longitudinal observations for 267 early rheumatoid arthritis (RA) patients of the United States Western Consortium (WC) cohort receiving first non-biologic DMARD treatment, we estimated the 1-year change in PSH (Δ PSH). Logistic regression analysis was used to estimate the association of improvement in Δ PSH with the core set of clinical and patient-reported components of disease activity scores (DAS). Most patients were more satisfied with health after 1 year of treatment (80%); few achieved DAS28-ESR minimal disease activity (27%) or remission (7%). Laboratory and joint count measures were not associated with improved 12-month PSH. Patients with greater HAQ-DI (P = 0.0473) and self-reported stiffness (P = 0.0669) were more likely to have a perceived overall health benefit from treatment. Regardless of objective disease status, patients are generally satisfied with first-line treatment, which could present a challenge to implementing DAS-guided treatment change. Patients with greater self-reported functional limitations might have lower expectations for treatment benefit and be less willing to modify their current therapy; subjective assessments of function and stiffness could be particularly useful in identifying these patients.
authors.affiliation: Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 8044, Rockville, MD 20892, USA. kovalchiksa@mail.nih.gov
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Kovalchik
authors.forename: Christina
authors.initials: C
authors.lastname: Charles-Schoeman
authors.forename: Dinesh
authors.initials: D
authors.lastname: Khanna
authors.forename: Harold E
authors.initials: HE
authors.lastname: Paulus
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014481:United States
chemical_list: D018501:Antirheumatic Agents