Health outcomes and unmet needs in patients with long-standing rheumatoid arthritis attending tertiary care in Greece: a cohort study.

ABSTRACT: BACKGROUND:No previous studies have characterized a patient's experience of rheumatoid arthritis (RA) management in Greece and unmet needs may exist despite a broad range of available treatments. Therefore, we assessed quality of life (QoL), functional ability, and healthcare resource utilization in patients with established RA and receiving treatment in a tertiary care setting in Greece. METHODS:This was a prospective, observational cohort of patients aged ?18?years, receiving any type of treatment for RA, and followed for 12?months at 7 rheumatology referral centers across mainland Greece (NCT01001182). Patient data were collected at the initial visit and 3, 6, and 9?months. QoL was evaluated using the Euro Quality of Life-5 dimensions questionnaire (EQ-5D) and functional ability was evaluated using the Health Assessment Questionnaire (HAQ). RESULTS:A total of 210 patients with RA were enrolled (76.7% women, mean?±?standard deviation [SD] age: 59.1?±?12.6?years, median [interquartile range] disease duration: 11.9 [5.0-16.0] years). Baseline mean?±?SD EQ-5D and HAQ scores were 0.57?±?0.32 and 0.75?±?0.63, respectively, and remained largely unchanged throughout the study. Post-hoc comparison showed that patients receiving non-biologic disease-modifying antirheumatic drugs (non-bDMARDs) had significantly higher EQ-5D and lower HAQ-DI scores compared with those receiving biologic DMARDs. A majority of patients reported having difficulty doing housework or other duties (61.4 and 61.9%, respectively), and 55.2% reported needing external support for these tasks. Positive correlation was observed between QoL and functional ability. Hospitalization at least once during the study occurred in 9.5% of the patients, and 12.5% of these cases were due to exacerbation of RA. At baseline, 52.4% of the patients were retired, with 38.5% of retirees having retired early due to RA. Among the patients who were retired at baseline, the mean?±?SD period from actual retirement to expected retirement age was 12.1?±?8.1?years. CONCLUSION:QoL and functional ability were positively correlated in patients with long-standing RA, with a large proportion showing impairments in both. Timely, target-oriented treatment initiated as soon as possible after diagnosis may help to improve patient-reported outcomes and limit the burden of RA. TRIAL REGISTRATION:ClinicalTrials.gov NCT01001182 . Registered 23 October 2009.

SUBMITTER: Boumpas DT 

PROVIDER: S-EPMC6489275 | biostudies-literature | 2019 Apr

REPOSITORIES: biostudies-literature