Elsevier

Gender Medicine

Volume 6, Issue 4, December 2009, Pages 544-554
Gender Medicine

Health-related quality of life in Swedish men and women with early rheumatoid arthritis

https://doi.org/10.1016/j.genm.2009.12.001Get rights and content

Abstract

Background: Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder that may adversely affect health-related quality of life (HRQoL) both in established and early disease.

Objectives: In patients with recent onset (<12 months) of RA, this extension of a previous study assessed HRQoL and the effect of disease activity over time.

Methods: Consecutive patients with recent onset of RA between March 1996 and November 1998 were followed for 6 years at the Department of Rheumatology of the University Hospital of Umeå in Sweden. Patients were requested to complete the 36-item Short Form (SF-36) Health Survey at 0, 24, 48, and 72 months. Gender differences were examined, and correlations between the SF-36 scales (with higher scores indicating better HRQoL) and data reflecting disease activity were analyzed.

Results: Fifty-one patients, 34 women and 17 men (mean age, 50.6 years; range, 20–78 years), participated in the study; in all, 41 patients completed the SF-36 at both 0 and 72 months. At inclusion (0 months), women reported significantly higher scores for physical role functioning, bodily pain, and social functioning compared with men (all, P < 0.05). At 72 months compared with 0 months, women reported significantly better mental health (P < 0.05), whereas men reported significantly better physical role functioning (P < 0.05), bodily pain (P < 0.01), mental health (P < 0.01), and vitality (P < 0.01). Additionally, at 72 months, the entire patient group rated physical role functioning and social functioning (both, P < 0.05), bodily pain and vitality (both, P < 0.01), and mental health (P < 0.001) as significantly better compared with the inclusion assessment. Overall improvement with time was significantly better for men than for women (P < 0.05). There were limited correlations between SF-36 point disease activity parameters and the SF-36 scores at 0 months (erythrocyte sedimentation rate vs physical functioning, mental health [both, P < 0.05], and bodily pain [P < 0.01]; 28-joint Disease Activity Score vs bodily pain [P < 0.05] and emotional role functioning [P < 0.01]) and at 72 months (C-reactive protein vs physical role functioning [P < 0.05]). Most of the physical subscales at inclusion correlated with the physical component summary (PCS) of the SF-36 questionnaire at 6 years.

Conclusions: At disease onset, women with early RA reported better HRQoL than did their male counterparts. After 6 years, women and especially men both experienced better HRQoL, and no significant gender differences remained in any of the SF-36 scales or values for disease activity parameters. The PCS score at disease onset was the best predictor of the PCS score after 6 years.

References (38)

  • DL Scott et al.

    What are the consequences of early rheumatoid arthritis for the individual?

    Best Pract Res Clin Rheumatol.

    (2005)
  • JE Ware et al.

    Overview of the SF-36 Health Survey and International Quality of Life Assessment (IQOLA) Project

    J Clin Epidemiol.

    (1998)
  • J Parker et al.

    Coping strategies in rheumatoid arthritis

    J Rheumatol.

    (1998)
  • I Wikström et al.

    Change in and predictors of leisure activities among patients with rheumatoid arthritis: A prospective study

    Scand J Rheumatol.

    (2005)
  • U Nordenskiöld et al.

    Questionnaire to evaluate the effects of assistive devices and altered working methods in women with rheumatoid arthritis

    Clin Rheumatol.

    (1998)
  • Y Yazici et al.

    Morning stiffness in patients with early rheumatoid arthritis is associated more strongly with functional disability than with joint swelling and erythrocyte sedimentation rate

    J Rheumatol.

    (2004)
  • AB Cranney et al.

    Driving problems in patients with rheumatoid arthritis

    J Rheumatol.

    (2005)
  • SM Russak et al.

    The use of rheumatoid arthritis health-related quality of life patient questionnaires in clinical practice: Lessons learned

    Arthritis Rheum.

    (2003)
  • TK Kvien et al.

    Quality of life in rheumatoid arthritis

    Scand J Rheumatol.

    (2005)
  • M Tuttleman et al.

    A cross sectional assessment of health status instruments in patients with rheumatoid arthritis participating in a clinical trial

    J Rheumatol.

    (1997)
  • DA Ruta et al.

    Measuring health status in British patients with rheumatoid arthritis: Reliability, validity and responsiveness of the short form 36-item health survey (SF-36)

    Br J Rheumatol.

    (1998)
  • TK Kvien et al.

    Performance of the Norwegian SF-36 Health Survey in patients with rheumatoid arthritis. II. A comparison of the SF-36 with disease-specific measures

    J Clin Epidemiol.

    (1998)
  • FN Birell et al.

    How does the short form 36 health questionnaire (SF-36) in rheumatoid arthritis (RA) relate to RA outcome measures and SF-36 population values? A crosssectional study

    Clin Rheumatol.

    (2000)
  • L Linde et al.

    Healthrelated quality of life: Validity, reliability, and responsiveness of SF-36, 15D, EQ-5D RAQoL, and HAQ in patients with rheumatoid arthritis [published correction appears in J Rheumatol. 2008;35:1688]

    J Rheumatol.

    (2008)
  • E West et al.

    Health-related quality of life in rheumatoid arthritis in Northern Sweden: A comparison between patients with early RA, patients with medium-term disease and controls, using SF-36

    Clin Rheumatol.

    (2005)
  • M Kosinski et al.

    Health-related quality of life in early rheumatoid arthritis: Impact of disease and treatment response

    Am J Manag Care.

    (2002)
  • I Thyberg et al.

    Recentonset rheumatoid arthritis: A 1-year observational study of correlations between health-related quality of life and clinical/laboratory data

    J Rehabil Med.

    (2005)
  • HM Lapsley et al.

    Living with rheumatoid arthritis: Expenditures, health status, and social impact on patients

    Ann Rheum Dis.

    (2002)
  • T Uhlig et al.

    Quantification of reduced health-related quality of life in patients with rheumatoid arthritis compared to the general population

    J Rheumatol.

    (2007)
  • Cited by (23)

    • Health-related quality of life in early psoriatic arthritis compared with early rheumatoid arthritis and a general population

      2021, Seminars in Arthritis and Rheumatism
      Citation Excerpt :

      At the study endpoint, at 52 weeks’ treatment with etanercept and methotrexate for RA and 24 weeks’ treatment with etanercept for PsA, both diseases had improved but RA still showed worse SF-36 scores than PsA in contrast to the current study. In our study, the inferior HRQoL for both diseases lacked sex differences, in contrast to a previous study of HRQoL in early RA that reported better scores in PF, BP, and SF at inclusion for women compared with men [31], though with a reduced difference after six years. Another study on early RA reported improvement over three years in all domains except VT and GH [32].

    • Secular changes in functional disability, pain, fatigue and mental well-being in early rheumatoid arthritis. A longitudinal meta-analysis

      2020, Seminars in Arthritis and Rheumatism
      Citation Excerpt :

      Although contact was made with 39 authors for additional longitudinal data, only 9 responded. With respect to the data collected, 36 (78%) had measures of pain [11,22,33,35,37–40,42,44–46,24,47,49–52,54,56–59,26,61,62,27–32], 13 (28%) had measures of fatigue [26–28,39,44,46,50,52,56], nine (20%) had measures of SF-36 [26,50,51,55,56,59,60], 37 (80%) had measures of the HAQ [11,22,34–41,43,44,24,45,47–52,55,56,59,25,61,62,26,28–30,32,33] and 37 (80%) had measures of DAS [11,22,33–40,42,44,24,45–47,49,50,52,53,55,56,59,26,61,62,27–32]. Alongside SF-36, other longitudinal measures of mental health were also collected, namely the Centre for Epidemiological Studies Depression Scale (CES-D) [49,53,58], The Arthritis Impact Measurement Scale (AIMS) [26] and the Hospital Anxiety and Depression Scale (HADS) [47,63], however the small numbers meant it was not possible to include them in the meta-analysis.

    • Distinct psychological distress trajectories in rheumatoid arthritis: Findings from an inception cohort

      2011, Journal of Psychosomatic Research
      Citation Excerpt :

      As such, the stability of trajectories after 3 years as described here is a novel finding. Considering the sample as a whole there was evidence for a slight reduction in distress in the first year after diagnosis, consistent with several previous reports [8–12]. Although we used a different methodology, our findings are comparable to those of Persson et al. [9] who also observed around 12% of the sample as experiencing chronically high levels.

    • Restless legs syndrome: Understanding its consequences and the need for better treatment

      2010, Sleep Medicine
      Citation Excerpt :

      When SF-36 scores are adjusted for the presence of unrelated comorbidity, patients with moderate to severe RLS show similar degrees of disease burden as patients with diabetes and depression, but even worse disease burden than those with osteoarthritis [16]. Other disease conditions associated with chronic pain symptoms, such as rheumatoid arthritis [18] and polyneuropathy [19], show similar disease burden if compared on the basis of SF-36 scores. The medical outcome survey (MOS) sleep questions not unexpectedly have shown increasing association with lower scores and higher disease burden in RLS patients [13].

    View all citing articles on Scopus
    View full text