title: Who are the patients with early arthritis with worse than death scores on the EQ-5D? Results from the ESPOIR cohort.
abstract: OBJECTIVE
  The EQ-5D is a five-dimension multi-attribute questionnaire widely used to calculate quality-adjusted life-year scores. We aimed to describe patients with early arthritis (EA) and EQ-5D < 0, a state worse than death, at baseline and over 2 years and determine aspects of EA associated with a negative score.
  
  
  METHODS
  EQ-5D scores for 813 patients were longitudinally assessed over 24 months. Characteristics and health status of patients with EQ-5D < 0 were analysed. Multivariate logistic regression was used to determine aspects of EA associated with a negative score.
  
  
  RESULTS
  At baseline, 90 (11%) patients had a negative EQ-5D score (median EQ-5D -0.052; range -0.530 to -0.011). Almost all patients had extreme pain/discomfort and at least moderate problems in anxiety/depression domain. These patients had lower educational level, greater disease activity, higher HAQ score (greater functional disability), greater pain and fatigue, lower Short Form 36 (SF-36) mental component scores and higher CRP levels than patients with EQ-5D ≥ 0 (all P < 0.001). In the logistic regression model, worse HAQ and SF-36 mental component scores were associated with EQ-5D < 0. Results were similar at 6, 12 and 24 months, with 25, 23 and 24 patients, respectively, in a state worse than death.
  
  
  CONCLUSIONS
  Pain or discomfort, often severe, is a key domain of the EQ-5D for patients with EA in a health state worse than death, and poor HAQ and SF-36 mental component scores were always independently associated with a state worse than death. EA patients may have specific needs necessitating better management of pain and psychological state.
authors.affiliation: Lorraine University, Paris Descartes University, Nancy, France. cecilegaujouxviala@yahoo.fr
authors.forename: Cécile
authors.initials: C
authors.lastname: Gaujoux-Viala
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Francis
authors.initials: F
authors.lastname: Guillemin
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.forename: Pierre
authors.initials: P
authors.lastname: Bourgeois
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Rat
mesh_terms: D000222:Adaptation, Physiological; D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000188:drug therapy / Q000523:psychology*; D015331:Cohort Studies; D004185:Disability Evaluation; D042241:Early Diagnosis; D005260:Female; D006801:Humans; D055809:Illness Behavior; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010147:Pain Measurement; D011379:Prognosis; D019057:Quality-Adjusted Life Years; D018570:Risk Assessment; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents