General Functional Status: Common Outcome Measures for Adults With Rheumatic Disease

Lane, C.; Givens, Deborah L.; Thoma, Louise M.

doi:10.1002/acr.24196

Cited by 3 publications

(3 citation statements)

References 113 publications

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“…Physical function was quantified with the Health Assessment Questionnaire (HAQ) disability index. The HAQ is a valid self-reported measure of physical function in adults with RA that assesses function in dressing, arising, eating, walking, hygiene, reaching, gripping, and usual activities (27,28). The range on the HAQ is 0 (indicating no functional limitation) to 3 (complete disability) (28).…”

Section: Significance and Innovationsmentioning

confidence: 99%

“…The HAQ is a valid self-reported measure of physical function in adults with RA that assesses function in dressing, arising, eating, walking, hygiene, reaching, gripping, and usual activities (27,28). The range on the HAQ is 0 (indicating no functional limitation) to 3 (complete disability) (28). Pain and fatigue were quantified using visual analog scales (VAS), where 0 indicates no pain or fatigue and 10 indicates the worst pain or fatigue imaginable (29,30).…”

Section: Significance and Innovationsmentioning

confidence: 99%

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Examining Rehabilitation Dose in Adults With Rheumatoid Arthritis: Association With Baseline Factors and Change in Clinical Outcomes

Thoma

Wellsandt

Wipfler

et al. 2023

Arthritis Care & Research

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Objective. To evaluate the association of baseline factors with rehabilitation dose and the association of rehabilitation dose with meaningful change in physical function, pain, and fatigue over 6 months among adults with rheumatoid arthritis (RA).Methods. Using data from the National Databank for Rheumatic Diseases registry, we extracted baseline characteristics and self-reported physical function (Health Assessment Questionnaire), pain (visual analog scale [VAS]), fatigue (VAS), rehabilitation dose (low: 1-2 visits, medium: 3-8 visits, high: >8 visits), and follow-up outcomes 6 months later. Changes in clinical outcomes were categorized as improved, no change, or worsened. We calculated odds ratios (ORs) and 95% confidence intervals (95% CIs) using proportional odds logistic regression models to examine the association of the baseline factors with rehabilitation dose and the association of rehabilitation dose with changes in clinical outcomes, adjusting for potential confounders.Results. The sample included 1,381 adults with a new episode of rehabilitation (dose: low 27%, medium 42%, high 31%). Worse baseline physical function (adjusted OR 1.29 [95% CI 1.04-1.60]), but not pain (adjusted OR 1.04 [95% CI 0.99-1.10]) or fatigue (adjusted OR 0.98 [95% CI 0.93-1.03]), were associated with a higher rehabilitation dose. A high rehabilitation dose was associated with a favorable change in physical function ), pain ), and fatigue (OR 1.45 [95% CI 1.06-1.99]) compared to a low dose; only the association with physical function change persisted in adjusted models (adjusted OR 1.41 [95% CI 1.03-1.92]).Conclusion. Using real-world data, this study supports a higher rehabilitation dose to improve physical function in adults with RA.

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Section: Significance and Innovationsmentioning

confidence: 99%

Section: Significance and Innovationsmentioning

confidence: 99%

Examining Rehabilitation Dose in Adults With Rheumatoid Arthritis: Association With Baseline Factors and Change in Clinical Outcomes

Thoma

Wellsandt

Wipfler

et al. 2023

Arthritis Care & Research

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“…Disability was assessed using the Health Assessment Questionnaire (HAQ) disability index. The HAQ is a valid, sensitive, and commonly used selfreported measure of physical function in adults with RA (10,11). The HAQ addresses 8 functional domains including dressing, arising, eating, walking, hygiene, reaching, gripping, and usual activities.…”

Section: Samplementioning

confidence: 99%

Association of Disease Activity and Disability With Rehabilitation Utilization in African American Adults With Rheumatoid Arthritis

Thoma

Cleveland

Jonas

et al. 2021

Arthritis Care & Research

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Objective. To examine the association of disease activity and disability with rehabilitation utilization in African American adults with rheumatoid arthritis (RA).Methods. We analyzed cross-sectional baseline data from the Consortium for the Longitudinal Evaluation of African Americans with RA (CLEAR) I and CLEAR II registry. Disease activity was quantified with the Disease Activity Score in 28 joints using the C-reactive protein level. Disability was measured with the Health Assessment Questionnaire. Rehabilitation utilization was determined by self-reported recall of physical therapy or occupational therapy visits in the prior 6 months or ever. We examined the association of disease activity and disability with rehabilitation utilization using separate binary logistic regression models to estimate odds ratios and 95% confidence intervals and adjusted for potential confounders. We repeated the analyses with the sample stratified by disease duration (early RA and established RA).Results. Of 1,067 participants, 14% reported utilizing rehabilitation in the prior 6 months, and 41% reported ever utilizing rehabilitation. Rehabilitation utilization in the prior 6 months was similar among those with early and established RA (12% versus 16%). A greater proportion of those with established RA reported any past rehabilitation utilization (28% versus 50%). Among those with established RA but not early RA, worse disability was associated with rehabilitation utilization in the prior 6 months. Disease activity was not associated with either outcome.Conclusion. Among African American adults with RA, rehabilitation utilization in the 6 months prior to assessment was low and associated with disability but not disease activity. Factors driving rehabilitation utilization are unclear.

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Predictors of quality of life, functional status, depression and fatigue in early arthritis: comparison between clinically suspect arthralgia, unclassified arthritis and rheumatoid arthritis

Torlinska,

Raza,

Filer

et al. 2024

BMC Musculoskelet Disord

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Background Rheumatoid arthritis (RA) is often preceded by symptomatic phases during which classification criteria are not fulfilled. The health burden of these “at-risk” stages is not well described. This study assessed health-related quality of life (HRQoL), function, fatigue and depression in newly presenting patients with clinically suspect arthralgia (CSA), unclassified arthritis (UA) or RA. Methods Cross-sectional analysis of baseline Patient-Reported Outcome Measures (PROMs) was conducted in patients from the Birmingham Early Arthritis Cohort. HRQoL, function, depression and fatigue at presentation were assessed using EQ-5D, HAQ-DI, PHQ-9 and FACIT-F. PROMs were compared across CSA, UA and RA and with population averages from the HSE with descriptive statistics. Multivariate linear regression assessed associations between PROMs and clinical and sociodemographic variables. Results Of 838 patients included in the analysis, 484 had RA, 200 had CSA and 154 had UA. Patients with RA reported worse outcomes for all PROMs than those with CSA or UA. However, “mean EQ-5D utilities were 0.65 (95%CI: 0.61 to 0.69) in CSA, 0.61 (0.56 to 0.66) in UA and 0.47 (0.44 to 0.50) in RA, which was lower than in general and older (≥ 65 years) background populations.” In patients with CSA or UA, HRQoL was comparable to chronic conditions such as heart failure, severe COPD or mild angina. Higher BMI and older age (≥ 60 years) predicted worse depression (PHQ-9: -2.47 (-3.85 to -1.09), P < 0.001) and fatigue (FACIT-F: 5.05 (2.37 to 7.73), P < 0.001). Women were more likely to report worse function (HAQ-DI: 0.13 (0.03 to 0.21), P = 0.01) and fatigue (FACIT-F: -3.64 (-5.59 to -1.70), P < 0.001), and residents of more deprived areas experienced decreased function (HAQ-DI: 0.23 (0.10 to 0.36), P = 0.001), greater depression (PHQ-9: 1.89 (0.59 to 3.18), P = 0.004) and fatigue (FACIT-F: -2.60 (-5.11 to 0.09), P = 0.04). After adjustments for confounding factors, diagnostic category was not associated with PROMs, but disease activity and polypharmacy were associated with poorer performance across all PROMs. Conclusions Patient-reported outcomes were associated with disease activity and sociodemographic characteristics. Patients presenting with RA reported a higher health burden than those with CSA or UA, however HRQoL in the pre-RA groups was significantly lower than population averages.

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General Functional Status: Common Outcome Measures for Adults With Rheumatic Disease

Cited by 3 publications

References 113 publications

Examining Rehabilitation Dose in Adults With Rheumatoid Arthritis: Association With Baseline Factors and Change in Clinical Outcomes

Examining Rehabilitation Dose in Adults With Rheumatoid Arthritis: Association With Baseline Factors and Change in Clinical Outcomes

Association of Disease Activity and Disability With Rehabilitation Utilization in African American Adults With Rheumatoid Arthritis

Predictors of quality of life, functional status, depression and fatigue in early arthritis: comparison between clinically suspect arthralgia, unclassified arthritis and rheumatoid arthritis

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