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Arthritis Rheumatol. 2019 Mar 20. doi: 10.1002/art.40869. [Epub ahead of print]

Disease burden in osteoarthritis (OA) is similar to rheumatoid arthritis (RA) at initial rheumatology visit and significantly greater 6-months later.

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1
Rush University Medical Center, Chicago, United States.

Abstract

OBJECTIVE:

To analyze disease burden in osteoarthritis (OA) according to MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) at initial and 6-month follow-up visits, compared to rheumatoid arthritis (RA) as a benchmark for high disease burden.

METHODS:

All patients with all diagnoses at Rush University rheumatology complete a paper MDHAQ at all visits, saved as a PDF in the electronic health record. MDHAQ 0-10 scores for physical function, pain, and patient global assessment, compiled into 0-30 RAPID3, and additional scales, of new OA and RA patients from 2011-2017 were compared at initial and 6-month follow-up visits. OA and RA patients, classified as self- or physician-referred, and RA "DMARD (disease-modifying anti-rheumatic drugs)-naïve" or "prior-DMARD," were compared using t-tests and analysis of variance (ANOVA), adjusted for age, disease duration, body mass index (BMI), education, and ethnicity.

RESULTS:

OA vs RA patients had higher age, BMI and disease duration. At initial visit, mean RAPID3 did not differ significantly in OA vs "DMARD-naïve" RA patients, whether self- or physician-referred [range 14.8-16.4 (p=0.38)], or in all OA vs "DMARD-naïve" RA vs "prior-DMARD" RA patients, 16.0, 15.5, 15.6, respectively (p=0.49). After 6-months, RAPID3 was improved to 14.3, 9.9, and 12.5, respectively, substantially more in RA than OA. Similar results were seen for most self-report measures, and in adjusted analyses.

CONCLUSION:

MDHAQ/RAPID3 scores are similar in OA or RA at initial visit, but higher in OA 6 months later, reflecting superior RA treatments. The same MDHAQ/RAPID3 allows comparisons of disease burdens in different diseases. This article is protected by copyright. All rights reserved.

KEYWORDS:

osteoarthritis; patient reported outcomes; rheumatoid arthritis

PMID:
30891933
DOI:
10.1002/art.40869

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