Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis

Abstract

BackgroundChronic diseases like osteoarthritis (OA) substantially affect different dimensions of quality of life (QoL). The aim of the study was to reveal possible factors which mainly influence general practitioners (GPs) assessment of patients' QoL.Methods220 primary care patients with OA of the knee or the hip treated by their general practitioner for at least one year were included. All GPs were asked to assess patients' QoL based on the patients' history, actual examination and existing x-rays by means of a visual analog scale (VAS scale), resulting in values ranging from 0 to 10. Patients were asked to complete the McMaster Universities Osteoarthritis Index (WOMAC) and the Arthritis Impact Measurement Scale2 Short Form (AIMS2-SF) questionnaire.ResultsSignificant correlations were revealed between "GP assessment" and the AIMS2-SF scales "physical" (rho = 0.495) and "symptom" (rho = 0.598) as well as to the "pain" scale of the WOMAC (rho = 0.557). A multivariate ordinal regression analysis revealed only the AIMS2-SF "symptom" scale (coefficient beta = 0.2588; p = 0.0267) and the x-ray grading according to Kellgren and Lawrence as significant influence variables (beta = 0.6395; p = 0.0004).ConclusionThe results of the present study suggest that physicians' assessment of patients' QoL is mainly dominated by physical factors, namely pain and severity of x-ray findings. Our results suggest that socioeconomic and psychosocial factors, which are known to have substantial impact on QoL, are underestimated or missed. Moreover, the overestimation of x-ray findings, which are known to be less correlated to QoL, may cause over-treatment while important and promising targets to increase patients' QoL are missed.

A prospective observational study to assess quality of life and prescription pattern in osteoarthritis patients at tertiary health centre in Mumbai

“…[5] OA is one of the chronic diseases which substantially affect different dimensions of quality of life. [6] Quality Of Life (QOL) refers to patients' appraisals of their current levels of functioning and satisfaction, compared to what they perceive to be ideal. [7] QOL has come into the focus of health care professionals and represents an increasingly important outcome parameter in many clinical trials [8] as per WHOs' new concept of health and disease.…”

Case management of arthritis patients in primary care: A cluster‐randomized controlled trial

“…The intervention was developed using a stepwise approach according to the recommendations of Campbell et al (26), including qualitative prestudies to reveal the needs of doctors and patients as well as possible obstacles to implementation (27). We also conducted a pilot study to test the assessment instruments and to reveal possible barriers to their implementation (28). After each step, assessment tools and the intervention were reconsidered and refined in a consensus process, including GPs and self‐help groups.…”

Development and validation of a needs‐based quality of life instrument for osteoarthritis

“…The knee and hand were the most common sites of pain (40.2%, respectively), followed by the foot (28.6%) and hip (23.9%). Multiple joint involvement was common (median number of joints affected 4 [range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]). Almost one-quarter of the sample was in paid employment and there was a wide range of educational achievement (Table 1).…”

“…Second, there is concern that outcome measures are too often derived from what clinicians, rather than patients, deem to be important. The fundamental flaw in such an approach is that clinicians are more likely to catastrophize disability (17) and ignore the socioeconomic and psychosocial issues (18), and are simply not good at predicting what patients consider to be important (19,20). Indeed, it has been argued that developing and validating outcome tools that are devised by clinicians without the inclusion of patient needs may be inappropriate and is likely to compromise the usefulness, validity, and accuracy of the tool (21).…”