Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine.
Department of Rheumatology, Jenin Government Hospital, Palestinian Ministry of Health, Jenin, Palestine.
Health Qual Life Outcomes. 2021 Oct 13;19(1):241. doi: 10.1186/s12955-021-01874-x.
Rheumatoid arthritis (RA) is a chronic autoimmune disorder, which has a significant impact on patients' health-related quality of life (HRQoL), and limits physical function as well as increases pain and fatigue. Therefore, this study aimed to evaluate the HRQoL and functional disability profile of patients with RA in Palestine to determine the socio-demographic and clinical features associated with low HRQoL and functional disability in patients with RA and to investigate the impact of drugs used on functional disability and HRQoL.
A cross-sectional, observational study conducted at rheumatology clinics in Northern West-Bank, Palestine (Alwatani Hospital-Nablus, Khalil Suleiman Hospital-Jenin, Thabet Thatbet Hospital-Tulkarem, and Darweesh Nazzal Hospital-Qalqilia). EuroQoL-5 Dimension scale (EQ-5D-5L) was used to evaluate HRQoL, Health Assessment Questionnaire, Disability Index (HAQ-DI) to evaluate the functional disability, and the Health Assessment Questionnaire pain visual analog scale (HAQ-VAS) to evaluate pain.
300 patients were included in the study, 229(76.3%) were females, the mean ± standard deviation age was 49 ± 13.10 years, and the median RA duration (lower-upper quartiles) was 6 (4-12) years. The median EQ-5D-5L index value and Euro QOL visual analogue scale (EQ-VAS) scores were 0.56 and 60, respectively. There was a significant strong positive correlation (R = 0.773; p < 0.001) between the EQ-5D-5L index values and the reported EQ-VAS scores. The median HAQ-DI and HAQ-VAS were 0.94 and 40, respectively. The results of multiple linear regression showed that treatment with biological DMARD (Etanercept), having work, higher income, absence of night pain, and absence of comorbid diseases were significantly associated with higher EQ-5D-5L index score (better HRQoL) and lower HAQ-DI scores (less disability). On the other hand, older age and the presence of morning stiffness were significantly associated with higher HAQ-DI scores (more disability).
This study revealed the impact of treatment, clinical variables, and socio-demographic factors on disability and HRQoL in RA patients. Healthcare providers should be aware of the association between treatment with biological DMARD and improved HRQoL and functional status to make early interventions that reduce disability and improve HRQoL in susceptible patients.
类风湿关节炎（RA）是一种慢性自身免疫性疾病，对患者的健康相关生活质量（HRQoL）有重大影响，并限制身体功能，增加疼痛和疲劳。因此，本研究旨在评估巴勒斯坦 RA 患者的 HRQoL 和功能障碍状况，确定与 RA 患者低 HRQoL 和功能障碍相关的社会人口学和临床特征，并探讨药物对功能障碍和 HRQoL 的影响。
这是一项在巴勒斯坦西岸北部的风湿病诊所进行的横断面、观察性研究（纳布卢斯的 Alwatani 医院、杰宁的 Khalil Suleiman 医院、图尔卡姆的 Thabet Thatbet 医院和盖勒吉利耶的 Darweesh Nazzal 医院）。采用欧洲五维健康量表（EQ-5D-5L）评估 HRQoL，采用健康评估问卷残疾指数（HAQ-DI）评估功能障碍，采用健康评估问卷疼痛视觉模拟量表（HAQ-VAS）评估疼痛。
本研究纳入了 300 名患者，其中 229 名（76.3%）为女性，平均年龄（标准差）为 49 岁（13.10 岁），中位 RA 病程（四分位间距）为 6 岁（4-12 岁）。中位 EQ-5D-5L 指数值和欧洲 QOL 视觉模拟量表（EQ-VAS）评分分别为 0.56 和 60。EQ-5D-5L 指数值与报告的 EQ-VAS 评分之间存在显著的强正相关（R=0.773；p<0.001）。中位 HAQ-DI 和 HAQ-VAS 分别为 0.94 和 40。多线性回归结果显示，接受生物 DMARD（依那西普）治疗、有工作、收入较高、无夜间疼痛和无合并症与较高的 EQ-5D-5L 指数评分（更好的 HRQoL）和较低的 HAQ-DI 评分（较少的残疾）显著相关。另一方面，年龄较大和晨僵与较高的 HAQ-DI 评分（更多的残疾）显著相关。
本研究揭示了治疗、临床变量和社会人口学因素对 RA 患者残疾和 HRQoL 的影响。医疗保健提供者应意识到接受生物 DMARD 治疗与改善 HRQoL 和功能状态之间的关联，以便及早干预，减少易感患者的残疾并改善 HRQoL。
