RT Journal Article
SR Electronic
T1 Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis: Observational Data from Southern Sweden
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1292
OP 1299
DO 10.3899/jrheum.150617
VO 43
IS 7
A1 Johan K. Wallman
A1 Jonas K. Eriksson
A1 Jan-Åke Nilsson
A1 Tor Olofsson
A1 Lars-Erik Kristensen
A1 Martin Neovius
A1 Pierre Geborek
YR 2016
UL http://www.jrheum.org/content/43/7/1292.abstract
AB Objective. To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA).Methods. Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005–2010. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare (patient care and drugs) and work loss costs (patients < 65 yrs) were studied in separate regression models, comparing standardized β coefficients by nonparametric bootstrapping to assess which measure best reflects costs. Analyses were conducted based on both individual means (linear regression, comparing between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs.Results. Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work loss costs were also more closely associated with EQ-5D than DAS28. The results of the linear models for healthcare costs were standardized β = 0.21 (95% CI 0.15–0.27), 0.16 (0.11–0.21), and –0.15 (−0.21 to −0.10) for HAQ/DAS28/EQ-5D, respectively (p < 0.05 for HAQ vs DAS28/EQ-5D). For work loss costs, the results were standardized β = 0.43 (95% CI 0.39–0.48), 0.27 (0.23–0.32), and −0.34 (−0.38 to −0.29) for HAQ/DAS28/EQ-5D, respectively (p < 0.05 for HAQ vs DAS28/EQ-5D and for EQ-5D vs DAS28).Conclusion. Overall, HAQ disability is a better marker of RA costs than DAS28 or EQ-5D HRQOL.