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Relationship of EQ-5D quality of life with the presence of co-morbidity and extra-articular features in patients with rheumatoid arthritis

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Abstract

Purpose

Rheumatoid arthritis (RA) is associated with extra-articular features (ExRA) and other co-morbidities. The aim of this study is to quantify their relative contribution to quality of life (QOL) in patients with RA.

Methods

A consecutive series of 114 ambulatory RA patients aged between 40 and 65 years were assessed by a research nurse on a single occasion. Assessment included a patient questionnaire (including EQ-5D), medication review and fasting venous blood sample. Medical records were reviewed by a rheumatologist for co-existing conditions. Multiple linear regression was used to adjust mean differences in EQ-5D in the presence/absence of co-existing conditions for age, sex, university education, arthritis duration, rheumatoid factor, erythrocyte sedimentation rate, current disease-modifying drug therapy, previous hand joint erosions and joint surgery.

Results

Mean age was 54 years (82 % female) and median arthritis duration 10 years. Unadjusted EQ-5D was −0.09 (95 % CI −0.18 to −0.01) lower in patients with any co-existing condition. EQ-5D scores were inversely correlated with the overall number of co-existing conditions (Spearman’s ρ −0.31, p = 0.001), number of co-morbidities (ρ −0.22, p = 0.02) and number of ExRA features (ρ −0.22, p = 0.02). There was a linear trend of lower EQ-5D with increasing number of co-existing conditions (p = 0.003). EQ-5D was −0.18 (95 % CI −0.33 to −0.02) lower in the presence of more than two co-existing conditions compared to none. Co-morbidity and ExRA features were associated with comparable adjusted reductions (−0.05 vs. −0.06) in EQ-5D scores.

Conclusion

A wide range of co-existing conditions are associated with poorer QOL in patients with RA.

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Abbreviations

CI:

Confidence interval

DMARD:

Disease-modifying anti-rheumatic drug

EQ-5D:

EuroQOL

ExRA:

Extra-articular features of rheumatoid arthritis

MCID:

Minimal clinically important difference

MLR:

Multiple linear regression

QOL:

Quality of life

RA:

Rheumatoid arthritis

RAAIX:

‘Rheumatoid Arthritis Augmentation Index’ study

SD:

Standard deviation

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Acknowledgments

The study was funded from a charitable source (NHS Grampian Rheumatology Endowments).

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Authors and Affiliations

  1. Institute of Applied Health Sciences, Aberdeen University Medical School, Polwarth Building at Foresterhill, Aberdeen, AB25 2ZD, Scotland, UK

    Michael A. Crilly, Marjorie C. Johnston & Corri Black

Authors
  1. Michael A. Crilly
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  2. Marjorie C. Johnston
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Correspondence to Michael A. Crilly.

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Crilly, M.A., Johnston, M.C. & Black, C. Relationship of EQ-5D quality of life with the presence of co-morbidity and extra-articular features in patients with rheumatoid arthritis. Qual Life Res 23, 1435–1443 (2014). https://doi.org/10.1007/s11136-013-0597-0

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