College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates.
Faculty of Pharmacy, Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
PLoS One. 2024 Oct 23;19(10):e0312557. doi: 10.1371/journal.pone.0312557. eCollection 2024.
The purpose of this study was to assess the health-related quality of life (HRQOL) and investigate the variables contributing to reduced HRQOL in patients with rheumatoid arthritis.
The present cross-sectional study was conducted on patients diagnosed with rheumatoid arthritis at two teaching hospitals in Jordan using a convenience sampling technique. The participants were interviewed face-to-face during the scheduled appointment at the outpatient rheumatology clinic. The HRQOL was evaluated by the validated EuroQol-5 Dimension (EQ-5D) questionnaire, which included the EQ-5D utility index that evaluated HRQOL in terms of 5 domains, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression, and the EQ-5D visual analogue scale (EQ-5DVAS), which evaluated HRQOL on a vertical scale ranging from 0 (worst imaginable health) to 100 (best imaginable health). The validated short version of the 19-item Compliance Questionnaire for Rheumatology (CQR-5) was used to evaluate medication adherence. The Clinical Disease Activity Index (CDAI) was used to assess disease activity among the study participants. A stepwise quantile regression model (q = 0.5) was conducted to explore the factors associated with the EQ-5DUtility Index and EQ-5DVAS scores.
In total, 261 patients with RA participated in the study. The median (interquartile range) of the EQ-5DUtility Index and EQ-VAS scores was 0.552 (0.006-0.726) and 0.506 (0.233-0.690), respectively. Regression analysis results demonstrated that medication non-adherence (regression coefficient (β) = -0.348, P<0.01), not performing regular physical activity (β = -0.209, P<0.01), and higher disease activity as measured by the CDAI score (β = -0.015, P<0.01) were significant predictors of a lower EQ-5DUtility Index score. In addition, medication non-adherence (β = -0.199, P<0.01), not performing regular physical activity (β = -0.117, P<0.01), increased body mass index (BMI) (β = -0.009, P<0.01), and higher CDAI score (β = -0.009, P<0.01) were significant predictors of low EQ-5DVAS score.
Patients with RA experienced significantly impaired HRQOL. Medication non-adherence, not performing regular physical activity, increased body weight, and increased disease activity were identified as determinants of poor HRQOL among patients with RA in the present study. Treating physicians should encourage regular physical activity, maintaining a healthy body weight, and controlling disease activity to improve HRQOL in patients with RA.
本研究旨在评估类风湿关节炎患者的健康相关生活质量（HRQOL），并探讨导致其 HRQOL 下降的因素。
本横断面研究在约旦的两家教学医院对类风湿关节炎患者进行，采用便利抽样技术。在门诊风湿病诊所的预约期间，对参与者进行面对面访谈。使用经过验证的 EuroQol-5 维度（EQ-5D）问卷评估 HRQOL，该问卷包括 EQ-5D 效用指数，该指数根据 5 个领域评估 HRQOL，包括移动性、自我护理、日常活动、疼痛/不适和焦虑/抑郁，以及 EQ-5D 视觉模拟量表（EQ-5DVAS），该量表在 0（想象中最糟糕的健康）到 100（想象中最好的健康）的垂直量表上评估 HRQOL。使用经过验证的类风湿关节炎 19 项依从性问卷（CQR-5）短版本评估药物依从性。使用临床疾病活动指数（CDAI）评估研究参与者的疾病活动。采用逐步分位数回归模型（q=0.5）探讨与 EQ-5D 效用指数和 EQ-5DVAS 评分相关的因素。
共有 261 名 RA 患者参加了这项研究。EQ-5D 效用指数和 EQ-VAS 评分的中位数（四分位距）分别为 0.552（0.006-0.726）和 0.506（0.233-0.690）。回归分析结果表明，药物不依从（回归系数（β）=-0.348，P<0.01）、不进行定期体育活动（β=-0.209，P<0.01）和 CDAI 评分较高（β=-0.015，P<0.01）是 EQ-5D 效用指数评分较低的显著预测因素。此外，药物不依从（β=-0.199，P<0.01）、不进行定期体育活动（β=-0.117，P<0.01）、体重指数（BMI）增加（β=-0.009，P<0.01）和 CDAI 评分较高（β=-0.009，P<0.01）是 EQ-5DVAS 评分较低的显著预测因素。
类风湿关节炎患者的 HRQOL 明显受损。本研究发现，药物不依从、不进行定期体育活动、体重增加和疾病活动增加是类风湿关节炎患者 HRQOL 差的决定因素。治疗医生应鼓励患者进行定期体育活动、保持健康体重和控制疾病活动，以改善类风湿关节炎患者的 HRQOL。
