Health‐related quality of life and its association with disease activity/functional status in rheumatoid arthritis: A cross‐sectional study from South India

Abstract

AbstractBackgroundRheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health‐related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ‐5D) tool and its association with functional status and disease activity.MethodsRA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ‐5D‐5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ‐VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score‐28 (DAS‐28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson's correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05.ResultsThe EQ‐5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ‐VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS‐28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ‐5D scores for RA patients were 0.78 (0.65–0.90) for no disease activity, 0.73 (0.65–0.80) for mild, 0.53 (0.32–0.74) for moderate and 0.47 (0.32–0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ‐5D.ConclusionRA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study's EQ‐5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.