Abstract
The aim of the present study was to assess the health-related quality of life (HRQoL) in patients with common rheumatic diseases referred to a rheumatology clinic and to compare it to the HRQoL of the general population. All patients with a new referral to the Department of Rheumatology of the Helsinki University Central Hospital were asked to participate in the study during the period from May 2002 to April 2003. A total of 295 patients with various rheumatic diseases were included in the analysis: 99 patients with rheumatoid arthritis (RA), 47 with arthralgia and fibromyalgia, 43 with other chronic arthritis (spondyloarthritis, psoriatic arthritis, enteropathic arthritis), 44 with osteoarthritis (OA), 22 with active reactive arthritis (ReA), 17 with systemic rheumatic diseases, 9 adults with juvenile idiopathic arthritis (JIA) and 14 with other diagnoses. HRQoL was measured by a disease specific instrument, the Stanford health assessment questionnaire (HAQ) and by a generic instrument, 15D. The mean baseline 15D score of the 295 included patients (0.822, SD 0.114) was significantly lower than of the general population (0.903, SD 0.098). Patients with OA and chronic arthritis reported the poorest HRQoL scores (both 0.810 on a 0–1 scale). In patients with RA and ReA the 15D score improved in a statistically significant and clinically important manner during the 8-month follow-up. Discomfort and symptoms caused by the disease were alleviated in a statistically significant manner in patients with RA as well as in those with arthralgia and fibromyalgia, chronic arthritis, ReA and systemic rheumatic diseases. HAQ score improved significantly in patients with RA, arthralgia and fibromyalgia, and ReA. The HRQoL of patients with common rheumatic diseases at referral to rheumatology clinic is significantly lower than the HRQoL of age-standardized general population. The most affected patients are those with OA, chronic arthritis and RA. A significant improvement in HRQoL with conventional interventions was achieved in patients with RA and ReA.
Similar content being viewed by others
References
Woolf AD, Pfleger B (2003) Burden of major musculoskeletal conditions. Bull World Health Organ 81:646–656
Woolf AD (2000) The bone and joint decade 2000–2010. Ann Rheum Dis 59(2):81–82
Osborne RH, Nikpour M, Busija L, Sundararajan V, Wicks IP (2007) Prevalence and cost of musculoskeletal disorders: a population-based, public hospital system healthcare consumption approach. J Rheumatol 34(12):2466–2475
Bazzichi L, Maser J, Piccinni A, Rucci P, Del Debbio A, Vivarelli L, Catena M, Bounani S, Merlini G, Bombardieri S, Dell′Osso L (2005) Quality of life in rheumatoid arthritis: impact of disability and lifetime depressive spectrum symptomatology. Clin Exp Rheumatol 23(6):783–788
Soderlin MK, Kautiainen H, Skogh T, Leirisalo-Repo M (2004) Quality of life and economic burden of illness in very early arthritis. A population based study in southern Sweden. J Rheumatol 31(9):1717–1722
Foster HE, Marshall N, Myers A, Dunkley P, Griffiths ID (2003) Outcome in adults with juvenile idiopathic arthritis: a quality of life study. Arthritis Rheum 48(3):767–775
Chorus AM, Miedema HS, Boonen A, Van Der Linden S (2003) Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age. Ann Rheum Dis 62(12):1178–1184
Rasanen P, Sintonen H, Ryynanen OP, Blom M, Semberg-Konttinen V, Roine RP (2005) Measuring cost-effectiveness of secondary health care: feasibility and potential utilization of results. Int J Technol Assess Health Care 21:22–31
Husted JA, Gladman DD, Farewell VT, Cook RJ (2001) Health-related quality of life of patients with psoriatic arthritis: a comparison with patients with rheumatoid arthritis. Arthritis Rheum 45(2):151–158
Fries JF (1983) The assessment of disability: from first to future principles. Br J Rheumatol 22(3 Suppl):48–58
Sintonen H (2001) The 15D instrument of health-related quality of life: properties and applications. Ann Med 33(5):328–336
Hakala M, Nieminen P, Manelius J (1994) Joint impairment is strongly correlated with disability measured by self-report questionnaires. Functional status assessment of individuals with rheumatoid arthritis in a population based series. J Rheumatol 21(1):64–69
Sintonen H (1995) The 15-D measure of health-related quality of life: II Feasibility, reliability and validity of its valuation system. National Center for Health Program Evaluation. National Health and Medical Research Council
Stavem K (1999) Reliability, validity and responsiveness of two multiattribute utility measures in patients with chronic obstructive pulmonary disease. Qual Life Res 8(1–2):45–54
Hawthorne G, Richardson J, Day NA (2001) A comparison of the Assessment of Quality of Life (AQoL) with four other generic utility instruments. Ann Med 33(5):358–370
Aromaa A, Koskinen S (2004) Health and functional capacity in Finland. Baseline results of the Health 2000 health examination survey. Vol. Series B 12/2004. Publications of National Public Health Institute 2004:171
Alonso J, Ferrer M, Gandek B, Ware JE Jr, Aaronson NK, Mosconi P, Rasmussen NK, Bullinger M, Fukuhara S, Kaasa S, Leplege A, IQOLA Project Group (2004) Health-related quality of life associated with chronic conditions in eight countries: results from the International Quality of Life Assessment (IQOLA) Project. Qual Life Res 13(2):283–298
Sprangers MA, de Regt EB, Andries F, van Agt HM, Bijl RV, de Boer JB, Foets M, Hoyemans N, Jacobs AE, Kempen GI, Miedema HS, Tijuhuis MA, de Haes HC (2000) Which chronic conditions are associated with better or poorer quality of life? J Clin Epidemiol 53(9):895–907
Picavet HS, Hoeymans N (2004) Health related quality of life in multiple musculoskeletal diseases: SF-36 and EQ-5D in the DMC3 study. Ann Rheum Dis 63(6):723–729
Lillegraven S, Kvien TK (2007) Measuring disability and quality of life in established rheumatoid arthritis. Best Pract Res Clin Rheumatol 21(5):827–840
Kosinski M, Kujawski SC, Martin R, Wanke LA, Buatti MC, Ware JE Jr, Perfetto EM (2002) Health-related quality of life in early rheumatoid arthritis: impact of disease and treatment response. Am J Manag Care 8(3):231–240
Davis JC, van der Heijde D, Dougados M, Woolley JM (2005) Reductions in health-related quality of life in patients with ankylosing spondylitis and improvements with etanercept therapy. Arthritis Rheum 53(4):494–501
Zink A, Thiele K, Huscher D, Listing J, Sieper J, Krause A, Gromnica-Ihle E, von Hinueber U, Wassenberg S, Genth E, Schneider M, German Collaborative Arthritis Centres (2006) Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis. J Rheumatol 33(1):86–90
Rosemann T, Laux G, Szecsenyi J (2007) Osteoarthritis: quality of life, comorbidities, medication and health service utilization assessed in a large sample of primary care patients. J Orthop Surg 2:12
Rabenda V, Manette C, Lemmens R, Mariani AM, Struvay N, Reginster JY (2007) Prevalence and impact of osteoarthritis and osteoporosis on health-related quality of life among active subjects. Aging Clin Exp Res 19(1):55–60
Ofluoglu D, Berker N, Guven Z, Canbulat N, Yilmaz IT, Kayhan O (2005) Quality of life in patients with fibromyalgia syndrome and rheumatoid arthritis. Clin Rheumatol 24(5):490–492
Birtane M, Uzunca K, Tastekin N, Tuna H (2007) The evaluation of quality of life in fibromyalgia syndrome: a comparison with rheumatoid arthritis by using SF-36 Health Survey. Clin Rheumatol 26(5):679–684
Flato B, Lien G, Smerdel A, Vinje O, Dale K, Johnston V, Sorskaar D, Moum T, Ploski R, Forre O (2003) Prognostic factors in juvenile rheumatoid arthritis: a case-control study revealing early predictors and outcome after 14.9 years. J Rheumatol 30(2):386–393
Peterson LS, Mason T, Nelson AM, O’Fallon WM, Gabriel SE (1997) Psychosocial outcomes and health status of adults who have had juvenile rheumatoid arthritis: a controlled, population-based study. Arthritis Rheum 40(12):2235–2240
Arkela-Kautiainen M, Haapasaari J, Kautiainen H, Vilkkumaa I, Malkia E, Leirisalo-Repo M (2005) Favourable social functioning and health related quality of life of patients with JIA in early adulthood. Ann Rheum Dis 64(6):875–880
Wolfe F, Michaud K, Pincus T (2005) A composite disease activity scale for clinical practice, observational studies, and clinical trials: the patient activity scale (PAS/PAS-II). J Rheumatol 32(12):2410–2415
Acknowledgments
We are grateful to the staff of the Rheumatology Outpatient Clinic of the Helsinki University Central Hospital for the help with distributing and collecting the questionnaires from the patients. The study was funded by research grants from the Helsinki and Uusimaa Hospital Group, National Graduate School of Musculoskeletal Disorders and Biomaterials, and Finska Läkareskällskapet.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
HUS QoL Study Group: M. Blom, M. Kekomäki, A.-M. Koivisto, R. P. Roine, O.-P. Ryynänen, P. Räsänen, H. Sintonen.
Rights and permissions
About this article
Cite this article
Laas, K., Roine, R., Räsänen, P. et al. Health-related quality of life in patients with common rheumatic diseases referred to a university clinic. Rheumatol Int 29, 267–273 (2009). https://doi.org/10.1007/s00296-008-0673-x
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00296-008-0673-x