Said Sanaa S, Johansson Kjell Arne, Nystad Tone Wikene, Mshiu Johnson Jeremia, Fevang Bjorg-Tilde Svanes
School of Health and Medical Sciences, The State University of Zanzibar, Zanzibar, Tanzania.
Department of Global Public Health and Primary Care, Bergen Center for Ethics and Priority Settings (BCEPS), Bergen, Norway.
Qual Life Res. 2025 May 7. doi: 10.1007/s11136-025-03974-3.
Rheumatoid arthritis (RA) is a chronic inflammatory illness that mainly affects the joints. Untreated, it causes deformity, poor health-related quality of life (HRQoL) and increased morbidity and mortality. There have been tremendous strides in RA therapies globally but with sparse availability in resource-limited settings. We aimed to evaluate HRQoL among patients with RA and its related factors.
132 patients with RA were enrolled and followed up for one year. The same number of healthy controls were recruited. HRQoL was assessed using the EuroQoL five-dimension five-level tool (EQ-5D). From the responses, utility and visual analog scale (VAS) scores were obtained. Analysis of variance and independent t tests were used to compare the utility and VAS scores for patient subgroups. Factors influencing HRQoL were investigated through multiple linear regression analysis. A p value of < 0.05 was considered significant.
At baseline, mean patient utility score was 0.50 ± 0.06 and increased to 0.66 ± 0.10 at one year (p < 0.05). Compared to controls, whose mean utility score was 0.93 ± 0.02, patients with RA at one year had lower HRQoL (p < 0.001). Time to diagnosis of ≥ 1 year and higher disease activity were associated with poorer HRQoL. Patient VAS scores also improved from baseline to one year but were significantly lower than controls.
HRQoL of patients with RA was lower than in controls but improved at one year indicating the impact of treatment. Reducing delays in diagnosis and initiating early and aggressive treatment may help to improve the HRQoL.
类风湿性关节炎（RA）是一种主要影响关节的慢性炎症性疾病。若不治疗，会导致畸形、健康相关生活质量（HRQoL）低下以及发病率和死亡率增加。全球范围内，RA治疗已取得巨大进展，但在资源有限的环境中，治疗方法却很少。我们旨在评估RA患者的HRQoL及其相关因素。
招募132例RA患者并随访一年。招募了相同数量的健康对照。使用欧洲五维度五水平健康量表（EQ - 5D）评估HRQoL。从回答中获得效用值和视觉模拟量表（VAS）得分。采用方差分析和独立t检验比较患者亚组的效用值和VAS得分。通过多元线性回归分析研究影响HRQoL的因素。p值<0.05被认为具有统计学意义。
基线时，患者平均效用值为0.50±0.06，一年后增至0.66±0.10（p<0.05）。与平均效用值为0.93±0.02的对照组相比，RA患者一年后的HRQoL较低（p<0.001）。诊断时间≥1年和疾病活动度较高与较差的HRQoL相关。患者的VAS得分从基线到一年也有所改善，但显著低于对照组。
RA患者的HRQoL低于对照组，但一年后有所改善，表明治疗有效果。减少诊断延迟并尽早开始积极治疗可能有助于改善HRQoL。
