Geryk Lorie L, Carpenter Delesha M, Blalock Susan J, DeVellis Robert F, Jordan Joanne M
UNC Eshelman School of Pharmacy, Division of Pharmaceutical Outcomes and Policy, University of North Carolina, Chapel Hill, USA.
University of North Carolina, Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina, Chapel Hill, USA.
Clin Exp Rheumatol. 2015 May-Jun;33(3):366-74. Epub 2015 Mar 24.
We investigated whether comorbidities differentially impacted health-related quality of life (HRQOL) for rheumatoid arthritis (RA) and osteoarthritis (OA) patients.
Adult patients with self-reported doctor-diagnosed RA (n=159) or OA (n=149) were recruited from multiple sources and completed an online cross-sectional survey. Patients self-reported sociodemographic variables, arthritis severity and comorbid conditions. HRQOL was assessed using the SF-12v2 and comorbidity counts were assigned using an expanded Functional Comorbidities Index. HRQOL (8 domain and 2 composite (physical and mental health) scores) was compared with norm-based general US population scores and between RA and OA patients to determine if they significantly differed from one another. Linear regression was used to test whether comorbidity count was associated with the physical and mental health of RA and OA patients.
OA and RA patients experienced significantly worse HRQOL across all dimensions compared with that of the general US population. There were no significant differences between RA and OA patients on any HRQOL dimension. A higher comorbidity count was associated with worse physical (p=0.0007) and mental (p=0.0295) health scores when controlling for patient gender, age, education, and arthritis severity.
Arthritis negatively impacted patients' HRQOL. OA patients in our sample perceived their condition as similarly disabling in terms of physical and mental health as RA patients. Arthritis patients with more chronic comorbid conditions may be at particular risk for poor physical and mental health. Providers should discuss management of comorbid conditions with arthritis patients.
我们调查了合并症对类风湿关节炎（RA）和骨关节炎（OA）患者健康相关生活质量（HRQOL）的影响是否存在差异。
从多个来源招募了自我报告经医生诊断为RA（n = 159）或OA（n = 149）的成年患者，并完成了一项在线横断面调查。患者自我报告社会人口统计学变量、关节炎严重程度和合并症情况。使用SF-12v2评估HRQOL，并使用扩展的功能合并症指数分配合并症计数。将HRQOL（8个领域和2个综合（身体和心理健康）得分）与基于标准的美国普通人群得分进行比较，并在RA和OA患者之间进行比较，以确定它们是否存在显著差异。使用线性回归来测试合并症计数是否与RA和OA患者的身体和心理健康相关。
与美国普通人群相比，OA和RA患者在所有维度上的HRQOL均显著更差。在任何HRQOL维度上，RA和OA患者之间均无显著差异。在控制患者性别、年龄、教育程度和关节炎严重程度后，合并症计数越高，身体（p = 0.0007）和心理健康（p = 0.0295）得分越差。
关节炎对患者的HRQOL产生负面影响。我们样本中的OA患者认为他们的身体和心理健康状况与RA患者同样致残。患有更多慢性合并症的关节炎患者可能特别容易出现身心健康不佳的风险。医疗服务提供者应与关节炎患者讨论合并症的管理。
