Objectives: Increasing severity in rheumatoid arthritis (RA) may result in poorer health-related quality of life (HRQoL), reduced work productivity and increased resource utilisation. This study investigated the impact of RA severity on HRQoL and healthcare resource utilisation among RA patients in Brazil.
Methods: Data were drawn from an observational cross-sectional study of consulting RA patients undertaken in November-December 2007. Rheumatologists (n=55) provided information for 526 RA patients, 521 of whom also completed patient self-completion (PSC) questionnaires. Physicians subjectively rated each patient's RA as mild, moderate or severe. The PSC included the Work Productivity and Activity Impairment questionnaire (WPAI), Health Assessment Questionnaire Disability Index (HAQ-DI) and HAQ-Pain score, EuroQoL-5D (EQ-5D) and Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue. Data on the number of hospitalisations and consultations to healthcare professionals in the past 12 months and RA drug therapy class received were also collected.
Results: Patients with severe RA had significantly impaired health and work status compared to those with mild/moderate disease. Overall work and activity impairment rose with increasing disease severity. Health status deteriorated as disease severity increased with worsening disability, pain, fatigue, quality of life and perceived general health status. Hospitalisation rate and frequency of physician consultations were also significantly greater among those with severe RA.
Conclusions: In Brazil, moderate to severe RA is associated with significant functional disability and morbidity. Disease severity should be considered when treating patients with RA. More aggressive treatment strategies may be needed to effectively manage patients with moderate to severe RA.