title: Relationship of EQ-5D quality of life with the presence of co-morbidity and extra-articular features in patients with rheumatoid arthritis.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is associated with extra-articular features (ExRA) and other co-morbidities. The aim of this study is to quantify their relative contribution to quality of life (QOL) in patients with RA.
  
  
  METHODS
  A consecutive series of 114 ambulatory RA patients aged between 40 and 65 years were assessed by a research nurse on a single occasion. Assessment included a patient questionnaire (including EQ-5D), medication review and fasting venous blood sample. Medical records were reviewed by a rheumatologist for co-existing conditions. Multiple linear regression was used to adjust mean differences in EQ-5D in the presence/absence of co-existing conditions for age, sex, university education, arthritis duration, rheumatoid factor, erythrocyte sedimentation rate, current disease-modifying drug therapy, previous hand joint erosions and joint surgery.
  
  
  RESULTS
  Mean age was 54 years (82% female) and median arthritis duration 10 years. Unadjusted EQ-5D was -0.09 (95% CI -0.18 to -0.01) lower in patients with any co-existing condition. EQ-5D scores were inversely correlated with the overall number of co-existing conditions (Spearman's ρ -0.31, p = 0.001), number of co-morbidities (ρ -0.22, p = 0.02) and number of ExRA features (ρ -0.22, p = 0.02). There was a linear trend of lower EQ-5D with increasing number of co-existing conditions (p = 0.003). EQ-5D was -0.18 (95% CI -0.33 to -0.02) lower in the presence of more than two co-existing conditions compared to none. Co-morbidity and ExRA features were associated with comparable adjusted reductions (-0.05 vs. -0.06) in EQ-5D scores.
  
  
  CONCLUSIONS
  A wide range of co-existing conditions are associated with poorer QOL in patients with RA.
authors: Institute of Applied Health Sciences, Aberdeen University Medical School, Polwarth Building at Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK, mike.crilly@abdn.ac.uk.
authors: Michael A
authors: MA
authors: Crilly
authors: Marjorie C
authors: MC
authors: Johnston
authors: Corri
authors: C
authors: Black
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012189:Retrospective Studies; D012218:Rheumatoid Nodule / Q000453:epidemiology / Q000523:psychology; D012606:Scotland / Q000453:epidemiology; D057566:Self Report; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents