RT Journal Article
SR Electronic
T1 Patient-reported Outcomes, Resource Use, and Social Participation of Patients with Rheumatoid Arthritis Treated with Biologics in Alberta: Experience of Indigenous and Non-indigenous Patients
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 760
OP 765
DO 10.3899/jrheum.170778
VO 45
IS 6
A1 Cheryl Barnabe
A1 Louise Crane
A1 Tyler White
A1 Brenda Hemmelgarn
A1 Gilaad G. Kaplan
A1 Liam Martin
A1 Walter P. Maksymowych
YR 2018
UL http://www.jrheum.org/content/45/6/760.abstract
AB Objective. To characterize patient-reported outcomes, resource use, and social participation during the course of biologic therapy for indigenous and non-indigenous patients with rheumatoid arthritis (RA).Methods. Patients initiating biologic therapy (2004 to 2012) were characterized longitudinally for patient-reported outcomes including physical function measured by the Health Assessment Questionnaire, EQ-5D, well-being [Medical Outcomes Study Short Form-36 (SF-36)], and visual analog scales for pain, fatigue, sleep, stiffness, and patient’s global assessment. Resource use, participation in activities of daily living, and effect of RA on work productivity were also evaluated for change during therapy.Results. Indigenous patients (n = 90) presented with significantly worse scores for global evaluation, pain, sleep, quality of life, well-being, and physical function compared to non-indigenous patients (n = 1400). All patient-reported outcomes improved significantly during treatment for patients in both groups, but pain, sleep, and SF-36 physical health score changes occurred at slower rates for indigenous patients [difference in slopes 0.09 (p = 0.029), 0.08 (p = 0.043), and −0.35 (p = 0.03), respectively]. Performance of daily activities was affected for 50% of indigenous compared to 37% of non-indigenous patients, with more use of community services and assistance from others. Employed indigenous patients reported twice the number of days being unable to work owing to RA compared to employed non-indigenous patients. Of the unemployed indigenous patients, 82% indicated they had stopped working because of arthritis, versus 48% of non-indigenous patients (p < 0.0001).Conclusions. Indigenous patients have greater consequences of RA regarding experienced symptoms, health-related quality of life, disruption of performance of activities of daily living, and reduced employment participation.