Assessing the functional status and quality of life of patients with rheumatoid arthritis.

OBJECTIVES To assess the impact of Rheumatoid Arthritis (RA) on functional working status, and health-related quality of life (HRQL) of patients. METHODS This is a descriptive study with 53 patients from a public rheumatology center in Montevideo, Uruguay. A series of instruments were used to assess pain, functional impairment, HRQL, and activity level: P-VAS (Pain Visual Analogue Scale), G-VAS (Global Status Visual Analogue Scale), HAQ (Health Assessment Questionnaire), SF-12 (Medical Outcomes Study Short Form 12), and DAS 28 (Disease Activity Score). Linear regression coeficients, t test, and ANOVA were used to investigate the associations among several independent parameters and the HRQL. Correlations between the assessments of general well-being made by physicians and patients were studied using the intraclass correlation coefficients (ICC). RESULTS High levels of disease activity (41.5%, severe activity; 26.5%, low activity or remission), severe pain (60%), and impact on global health status (median G-VAS 40, range: 0-100) were observed. More than 70% of the patients had HAQ rates indicating moderate to severe disability. The SF-12 PCS (Physical component Summary) had mean scores of 31.5 points (range 15.2- 59.5; SD=10.1) while those of the MCS (Mental Component Summary) were 37.9 points (range: 15.7 - 66.4; SD=14.6). One or more years of disease evolution and the level of activity were determining factors of HRQL scores. CONCLUSIONS The study showed that RA is associated with higher disease burden, reflected on pain, impact on global health, and functional and working status, as well as the physical and emotional dimensions of the HRQL. The need for changes in the treatment of this psychologically vulnerable group of patients is paramount.