Background Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects joints with some extraarticular involvement. If inappropriately treated, it usually results in persistent joint pain, irreversible deformities, and functional disability, leading to poor quality of life. Our objective was to evaluate health-related quality of life (HRQoL) and related factors in patients with RA. Methods Four hundred sixty-four patients from the Rheumatoid Arthritis registries of Siriraj and Phramongkutklao teaching hospitals were enrolled. Sociodemographic, clinical and laboratory data related to disease activity, and functional status were collected. HRQoL was assessed using the Thai version of EuroQol five dimensional questionnaire (EQ-5D) and EQ global health visual analogue scale (EQ VAS). Univariate and multivariate analyses were employed to identify factors related to HRQoL. Results Eighty-five percent were female with a mean age ± SD of 59.15 ± 11.43 years and a mean disease duration ± SD of 11.53 ± 8.3 years. The mean educational level ± SD was 9.42 ± 5.21 years. Almost half were unemployed or retired (47%). They had moderate disease activity (mean cumulative DAS28 ± SD, 3.5 ± 0.8) and mild functional impairment (mean HAQ ± SD, 0.70 ± 0.68). The mean EQ-5D ± SD (0–1) was 0.87 ± 0.13 and mean EQ VAS ± SD (0–10) was 7.94 ± 1.7. Based on the EQ-5D domain, 49% reported that they had no problem with mobility, 83% had no difficulties with self-care, 65% had no difficulties with usual activity, 30% had no pain or discomfort, and 61% had no depression or anxiety. The relationship between problems of each dimension in EQ-5D significantly increased according to severity of RA assessed by the Disease Activity Score (DAS) 28 and Health Assessment Questionnaire (HAQ) ( p <  0.01). In multivariate analyses, high cumulative disease activity, functional disability, depression, and anxiety were negatively associated with EQ-5D (adjusted R 2 0.38, p <  0.001) and EQ VAS (adjusted R 2 0.19, p <  0.001). Conclusion Disease severity and psychological disturbance have a negative impact on quality of life in patients with RA. These factors should be considered in management of RA patients to improve the standard of care. Electronic supplementary material The online version of this article (10.1186/s41927-019-0080-9) contains supplementary material, which is available to authorized users.

Aim To investigate the prevalence of and factors associated with depression and anxiety in patients with rheumatoid arthritis (RA). Methods This prospective cross‐sectional study included patients who were consecutively enrolled in the Siriraj Rheumatoid Arthritis Registry or the Thai Army Rheumatoid Arthritis Cohort during the September 2016 to March 2018 study period. Demographic data and clinical variables, including disease activity, functional status, health‐related quality of life, and cognitive function, were collected. Depression and anxiety were assessed using the Thai version of the Hospital Anxiety and Depression Scale (Thai HADS). Results Four hundred and sixty‐four patients were included. Mean age was 59 years, median disease duration was 9.9 years, and 85% of patients were female. Based on the Thai HADS cutoff value of 8 or higher, 12.5% and 14.5% of patients had some degree of depression and anxiety, respectively. Multivariate analysis revealed global health score (risk ratio [RR]: 0.98, P = .001) to be the only factor independently negatively associated with depression. Regarding anxiety, functional disability (RR: 2.46, P = .004) and married status (RR: 2.43, P = .009) were significantly associated with increased risk, whereas disease duration of 10 years or more (RR: 0.45, P = .007) and global health score (RR: 0.97, P < .001) were significantly associated with decreased risk of developing anxiety. Conclusion Depression and anxiety are common in patients with RA. Patients' perceptions of their current health are significantly related to mood disorders. Therefore, mental health status, especially mood disturbances, should be addressed in routine practice to improve quality of life in RA.

Aim:To identify factors associated with the EuroQol-5 Dimensions-5 levels (EQ-5D-5L) and patient acceptable symptom state (PASS) and to estimate health utility (HU) in Thai patients with psoriatic arthritis (PsA). Methods:A cross-sectional study of consecutive PsA patients visiting Siriraj Hospital was performed between 31 May, 2012 and 31 March, 2016. Data of patient demographics, HU outcomes (Thai EQ-5D-5L), disease activity (Disease Activity Index for Psoriatic Arthritis [DAPSA], the Clinical DAPSA [cDAPSA], the minimal disease activity [MDA]), and the Health Assessment Questionnaire (HAQ) were collected.Regression analyses were used to explore factors associated with each EQ-5D domain, HU, and PASS. Results:Of 129 PsA patients, the mean age was 47.6 years; 53.5% were male. The mean HU was 0.76. Univariable analysis showed lower disease activity and less impaired function were significantly associated with higher HU and no to mild problem in each EQ-5D domain. Multivariable analysis showed HAQ and disease activity indices (cDAPSA, DAPSA, MDA) adjusting for age, had good goodness-of-fit to HU (adjusted R 2 : 0.63-0.65). Patients answering "yes" to PASS had significantly longer disease duration of PsA, higher HU, lower disease activity, less disability, and were more often married than those answering "no" to PASS. Pain problem was the most important association to PASS adjusting for other domains and age. Conclusions:Disease activity and functional status in PsA patients were significant factors related to HU and PASS. To improve quality of life, the goal of treatment should be achieving remission, improving function, and controlling pain. K E Y W O R D ScDAPSA, EQ-5D-5L, MDA, PASS, psoriatic arthritis | 701 CHIOWCHANWISAWAKIT eT Al.