title: Health related quality of life in rheumatoid arthritis, osteoarthritis, diabetes mellitus, end stage renal disease and geriatric subjects. Experience from a General Hospital in Mexico.
abstract: BACKGROUND
  Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases.
  
  
  OBJECTIVE
  The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group.
  
  
  METHODS
  We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was≥65 years, and the control group≥30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea.
  
  
  RESULTS
  We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (P<.0001). The SF-36 scores were different between control group and others groups (P=0.007). The worst HRQoL was in end-stage renal disease group (±SD: 48.06±18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2±2.4) and RA (5.1±3). HAQ was higher in OA compared to RA (1.12±0.76 vs 0.82±0.82, respectively; P=.001). Forty five percent of all subjects had depression.
  
  
  CONCLUSIONS
  The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention.
authors.affiliation: Unidad de Investigación Dr. Mario Alvizouri Muñoz, Hospital General Dr. Miguel Silva, Morelia, Michoacán, México. Electronic address: yesam_82@hotmail.com.
authors.forename: Yesenia
authors.initials: Y
authors.lastname: Ambriz Murillo
authors.affiliation: Servicio de Reumatología, Hospital del Servicio Andaluz de Salud (SAS) de Jerez, Jerez de la Frontera, España.
authors.forename: Raul
authors.initials: R
authors.lastname: Menor Almagro
authors.affiliation: Servicio de Medicina Interna, Hospital General Dr. Miguel Silva, Morelia, Michoacán, México.
authors.forename: Israel David
authors.initials: ID
authors.lastname: Campos-González
authors.affiliation: Unidad de Investigación Dr. Mario Alvizouri Muñoz, Hospital General Dr. Miguel Silva, Morelia, Michoacán, México; Servicio de Medicina Interna, Hospital General Dr. Miguel Silva, Morelia, Michoacán, México; Servicio de Reumatología, Hospital General Dr. Miguel Silva, Morelia, Michoacán, México.
authors.forename: Mario H
authors.initials: MH
authors.lastname: Cardiel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid; D016022:Case-Control Studies; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005260:Female; D006305:Health Status Indicators; D006769:Hospitals, General; D006801:Humans; D007676:Kidney Failure, Chronic; D008297:Male; D008800:Mexico; D008875:Middle Aged; D010003:Osteoarthritis; D011788:Quality of Life
keywords: Artritis reumatoide; Calidad de vida relacionada con la salud; Chronic diseases; Diabetes mellitus; End-stage renal disease; Enfermedades crónicas; Geriatric subjects; Health-related quality of life; Insuficiencia renal terminal; Osteoarthritis; Osteoartritis; Población geriátrica; Rheumatoid arthritis