Comparison and sensitivity to change of self-report scales to assess difficulty, dissatisfaction, and pain in performing activities of daily living over one and five years in rheumatoid arthritis.

We analyzed the longitudinal sensitivity to change of three self-report activities of daily living (ADL) scales over 1 and 5 years in 982 patients with rheumatoid arthritis (RA) from 15 private practices. Over 1 year, the ADL difficulty status worsened in 28.3% of the patients, remained the same in 50.2%, and improved in 21.5%. Over 5 years, 41.3% worsened, 38.8% stayed the same, and 19.9% were improved. Similar percentages for 1- and 5-year changes were found for the ADL dissatisfaction and pain scales. The effect sizes for change over 1 and 5 years for the ADL difficulty, dissatisfaction, and pain scales were--(-)0.05, 0.01, and -0.02, and -0.28, -0.20, and -0.14, respectively, indicating small to moderate declines. These data indicate that the three ADL scales are sensitive to change in status, and ADL change status scores after 1 and 5 years were significantly correlated with each other (r = 0.49-0.68, all p < 0.001). Monitoring of these three constructs may be helpful in the longitudinal evaluation of some patients with RA.