title: Is the state of health of rheumatoid arthritis patients receiving adequate treatment, predictable? - Results of a survey.
abstract: BACKGROUND
  A survey was conducted to evaluate whether a steady improvement in the quality of life of Rheumatoid Arthritis (RA) patients as frequently reported in clinical studies, does actually occur. The focus of this study laid on the personal perception of RA patients. How do patients who have been treated along accepted guidelines see the state of their health and their joint pain at different points in time?
  
  
  METHODS
  RA patients were asked to complete a questionnaire and return it to an opinion research centre. The questionnaire, which was developed by the authors, was divided into the areas: demography, symptom description and medical care, as well as the illness in a personal context. Three telephone interviews followed in monthly intervals when the patients' feelings about their illness, their every-day coping mechanisms and their social lives were rated. Intra-subject correlation and the level of agreement among patients when assessed at three different points within a two month period, was determined.
  
  
  RESULTS
  127 patients replied to the questionnaire. RA exerts a significant impact on a patient's daily life. Average ratings of current state of health and joint pain (answered on a 5-part scale extending from 1 (very good) to 5 (very bad)) range between 2.6 and 2.9 all three times. However, intra-subject correlation between the different assessment times, is in general quite modest. Concerning the question: "How is your join pain today?" only 14 of 127 participants express identical ratings all three times , while in one third of the participants, a difference of two digits on the 5-part scale, at least twice had to be noticed. Intra-class correlation coefficients between answers at different points are often much smaller than 0.5. Results were similar in all subgroups analysed (men vs. women; patients receiving biologics vs. those not receiving biologics; disease duration ≤3 years vs. 4 to 10 years vs. ≥11 years).
  
  
  CONCLUSIONS
  On an individual level personal assessments of health, well-being and joint pain are nevertheless unsteady even within the timeframe of two months. This is why, even now, RA patients still cannot plan their lives as non-affected people can.
authors.affiliation: Rheumatologist and Qualified Health Care Manager, Wels, Austria. rudolf.puchner@cc-net.at.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Puchner
authors.affiliation: Rheumatology and Immunology Division, Department of Internal Medicine, Medical University of Graz, Graz, Austria. hans.peter.brezinsek@meduni-graz.at.
authors.forename: Hans Peter
authors.initials: HP
authors.lastname: Brezinschek
authors.affiliation: Department of Medical Statistics, Informatics and Health Economics, Medical University of Innsbruck, Innsbruck, Austria. josef.fritz@i-med.ac.at.
authors.forename: Josef
authors.initials: J
authors.lastname: Fritz
authors.affiliation: Department of Internal Medicine I, Medical University of Innsbruck, Innsbruck, Austria. manfred.herold@i-med.ac.at.
authors.forename: Manfred
authors.initials: M
authors.lastname: Herold
authors.affiliation: Department of Internal Medicine II, Kaiser Franz Josef Hospital, Vienna, Austria. monika.mustak@wienkav.at.
authors.forename: Monika
authors.initials: M
authors.lastname: Mustak
authors.affiliation: Department of Medicine II, Centre for Rheumatology, Stockerau State Hospital, Stockerau, Austria. thomas.nothnagl@stockerau.lknoe.at.|Karl Landsteiner Institute for Clinical Rheumatology, Stockerau, Austria. thomas.nothnagl@stockerau.lknoe.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Nothnagl
authors.affiliation: Department of Orthopaedic Surgery, Medical University of Vienna, Vienna, Austria. stephan.puchner@meduniwien.ac.at.
authors.forename: Stephan E
authors.initials: SE
authors.lastname: Puchner
authors.affiliation: Department of Internal Medicine III, Medical University of Salzburg, Salzburg, Austria. a.studnicka-benke@salk.at.
authors.forename: Andrea
authors.initials: A
authors.lastname: Studnicka-Benke
authors.affiliation: Rheumatology and Immunology Division, Department of Internal Medicine, Medical University of Graz, Graz, Austria. leeb.rheuma@aon.at.|Department of Medicine II, Centre for Rheumatology, Stockerau State Hospital, Stockerau, Austria. leeb.rheuma@aon.at.|Karl Landsteiner Institute for Clinical Rheumatology, Stockerau, Austria. leeb.rheuma@aon.at.
authors.forename: Burkhard F
authors.initials: BF
authors.lastname: Leeb
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000328:Adult; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D001317:Austria; D017281:Cost of Illness; D005260:Female; D019538:Health Care Surveys; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010361:Patients / Q000523:psychology*; D010465:Perception; D011788:Quality of Life; D012919:Social Behavior; D011795:Surveys and Questionnaires; D013689:Telephone; D013997:Time Factors; D016896:Treatment Outcome