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Int J Rheum Dis. 2018 Sep;21(9):1709-1715. doi: 10.1111/1756-185X.13345.

Disability and health-related quality of life in Chinese patients with rheumatoid arthritis: A cross-sectional study.

Zhou Y1, Wang X2, An Y1, Zhang X1, Han S3, Li X4, Wang L4, Wang C4, Wang Y5, Yang R5, Wang G6, Lu X6, Zhu P7, Chen L7, Liu J8, Jin H8, Liu X9, Sun L9, Wei P10, Wang J10, Chen H10, Cui L11, Shu R11, Zhang Z12, Li G12, Li Z13, Yang J13, Li J14, Jia B14, Zhang F15, Tao J15, Lin J16, Wei Q16, Liu X17, Ke D17, Hu S18, Ye C18, Yang X19, Li H19, Huang C20, Gao M20, Li X21, Song L21, Wang Y22, Wang X22, Mu R1, Su Y1, Li Z1.

Author information

1
Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, China.
2
Duoding Street Community Health Center, Peking University Shougang Hospital, Beijing, China.
3
Department of Rheumatology and Immunology, Peking University Shougang Hospital, Beijing, China.
4
Department of Rheumatology and Immunology, Second Hospital of Shanxi Medical University, Taiyuan, China.
5
Department of Rheumatology and Immunology, The First Affiliated Hospital, Baotou Medical College, Baotou, China.
6
Department of Rheumatology, China-Japan Friendship Hospital, Beijing, China.
7
Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
8
Department of Rheumatology and Immunology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
9
Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing, China.
10
Department of Rheumatology and Immunology, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
11
Department of Rheumatology and Immunology, The Affiliated Kailuan Hospital of North China Coal Medical University, Tangshan, China.
12
Department of Rheumatology and Clinical Immunology, Peking University First Hospital, Beijing, China.
13
Department of Rheumatology and Immunology, Bethune International Peace Hospital of PLA, Shijiazhuang, China.
14
Department of Rheumatology and Immunology, Handan Central Hospital, Handan, China.
15
Department of Rheumatology and Immunology, The People's Hospital of Hebei Province, Shijiazhuang, China.
16
Department of Rheumatology, the People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
17
Department of Rheumatology and Immunology, Beijing Shunyi Hospital, Beijing, China.
18
Department of Rheumatology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
19
Department of Rheumatology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
20
Department of Rheumatology and Immunology, Beijing Hospital, Beijing, China.
21
Department of Rheumatology, Shandong University Qilu Hospital, Jinan, China.
22
Department of Rheumatology, Second Hospital of Lanzhou University, Lanzhou, China.

Abstract

AIM:

The objective of this study was to evaluate the impact of rheumatoid arthritis (RA) on physical function and health-related quality of life (HRQoL) in China.

METHOD:

A cross-section survey was conducted in 21 general hospitals in China. Eight hundred and seven patients were recruited. Data on demographics, clinical data, physical function (Stanford Health Assessment Questionnaire Disability Index, HAQ-DI) and HRQoL (Study Short Form 36 Health Survey, SF-36) were collected on site.

RESULTS:

In our cohort, physical function was impaired in 77.6% of patients (HAQ-DI >0). The median (interquartile range, IQR) of HAQ-DI was 0.750 (0.125, 1.500). Rated by HAQ-DI 0-1, >1-2, and >2-3, percentage of patients with mild, moderate and severe disability was 61.0%, 25.4%, and 13.6%, respectively. Older age, long disease duration, presence of extra-articular manifestations, tender joint count (TJC), overall status (assessed by patient Global Visual Analogue Scale [G-VAS] and physician G-VAS) and lacking disease-modifying anti-rheumatic drugs were identified as predictive factors for worse physical function (P < .05). The composite scores of SF-36 in the observed patients were: physical component summary 40.4 (IQR 27.4, 60.3), and mental component summary 49.0 (IQR 33.6, 70.9). Impaired physical health may be predicted by low income, presence of extra-articular manifestations, TJC, patient G-VAS and high HAQ-DI. Predictors for suboptimal mental health were low income, physical labor, married status, increased swollen joint count (SJC), physician G-VAS and high HAQ-DI.

CONCLUSION:

Rheumatoid arthritis has profound effects on physical function and HRQoL in Chinese patients. Patients with identified predictive factors for poor outcome should be closely monitored.

KEYWORDS:

disability evaluation; patient reported outcome measures; quality of life; rheumatoid arthritis

PMID:
30345647
DOI:
10.1111/1756-185X.13345
[Indexed for MEDLINE]

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