The assessment of functional capabilities and health-related quality of life in patients with rheumatoid arthritis approved for treatment with biologic agents
Bulgarian Medical Journal, 2023, 17(4), 61-67.
S. Neycheva1, E. Naseva2, Z. Batalov3, R. Karalilova3, A. Batalov3
1 Department of Rheumatology, Military Medical Academy, MHAT – Sofia
2 Faculty of Public Health “Prof. Tsekomir Vodenicharov, MD, DSc”, Medical University – Sofia
3 Clinic of Rheumatology, UMHAT “Kaspela”, Medical University – Plovdiv
Abstract. Background: Rheumatoid arthritis is a disabling disease that is associated with chronic pain, impaired functional capacity and worsened quality of life. The advent of biologic disease-modifying anti-rheumatic drugs (bDMARDs) gives a new therapeutic opportunity for patients with seropositive rheumatoid arthritis. The goal of the treatment is not only to reduce a disease activity, but maintain the physical and emotional health of the patients. Purpose: The objective of this study was to assess the functional capacity and health-related quality of life in patients with rheumatoid arthritis before initiation of treatment with biologic disease-modifying anti-rheumatic drugs. Material and methods: This study was a retrospective observational cohort study that included 179 patients. At the baseline visit, patients were interviewed by a physician, and demographic data including gender, age, disease duration and prior exposition to bDMARD, were collected. The patient’s physical function/disability was evaluated through self-reported HAQ-DI, and the health-related quality of life was assessed using the SF-36. Results: HAQ-DI medians differ significantly by gender (p = 0.007), as well as for some SF-36 domains, including “Physical functions” (p = 0.01), “Role emotional” (p = 0.04), “General health” (p = 0.02), “Physical component” (p = 0.007). The results for the “Mental component” can be interpreted as borderline (p = 0.06). The values are higher among men compared to women. We did not find a correlation between age and HAQ-DI. Disease durations impacts some SF- 36 domains, but the relationship is weak with opposite direction (Spearman‘s rho = -0,158). We observed a correlation between HAQ-DI and disease duration among women (p = 0.023), but the relationship is week (Spearman‘s rho = 0,186). Conclusions: HAQ-DI and SF-36 questionnaires show good reliability for assessing the quality of life assessment among patients with seropositive rheumatoid arthritis. Health-related quality of life is lower among women and those with longer disease duration.
Key words: rheumatoid arthritis, health-related quality of life, treatment, HAQ-DI, SF-36
Address for correspondence: Stefka Neycheva, MD, Military Medical Academy, UMHAT – Sofia, 3 Sv. Georgi Sofiyski, 1606 Sofia, Bulgaria, e-mail: stneicheva@yahoo.com