Predictors of severe self-reported disability in RA in a long-term follow-up study

Abstract

Health care providers should be aware of the subgroup of patients with more severe symptoms of pain and impaired function at disease onset since they have an increased risk of being in the most disabled tertile of rheumatoid arthritis patients several years later. Health care providers should assess pain and function and act on high pain and impaired function already at disease onset as they proved to be predictors of patient-reported outcomes controlled for inflammatory parameters. These findings support European guidelines and research findings that patients with high pain and impaired function despite of well-managed inflammatory parameters should early in the disease course be referred to multidisciplinary treatment for supplementary regime.

Baseline patient reported outcomes are more consistent predictors of long-term functional disability than laboratory, imaging or joint count data in patients with early inflammatory arthritis: A systematic review

“…The average difference between the HAQ scores of women and men ranged from 0.08 [30] to 0.38 [31], based on studies reporting a significant association between female gender and higher HAQ score from linear regression analysis. A study by Malm et al including 1.4k patients followed for 15 years reported that women had a two and a half times increased odds of having a HAQ score over 0.75 at the 15th year assessment compared to men (OR 2.53, 95% CI: 1.85, 3.46) [32].…”

“…One study ( N = 191) reported that each unit increase in HAQ score at baseline was associated with a 0.39 ( p = 0.0001) increase in HAQ score at five years [34]. Another study ( N = 1.4k) reported that each unit increase in baseline HAQ was associated with a 3.57 (95% CI: 2.84, 4.49) times increased odds of having HAQ > 0.75 at 15th year assessment [32].…”

“…One study using generalised estimating equations analysis over eight years of follow-up, reported that each centimetre increase in pain VAS at baseline was associated with an average increase of 0.06 HAQ score over follow-up [35]. Two studies reported a 2% increased odds in being in a higher HAQ category at follow-up per millimetre increase in pain VAS at baseline, one after seven years of follow-up [36], the other after 15 [32].…”

The influence of lifestyle habits on quality of life in patients with established rheumatoid arthritis—A constant balancing between ideality and reality

“…The limitations can be influenced by biological factors, such as cartilage damage, joint degeneration, inflammation, swelling, and deconditioning (Keefe et al, 2002 ). It is known that pain and impaired function affect everyday activities in patients with early and longstanding RA (Malm, Bergman, Andersson, & Bremander, 2015 ; Thyberg, Dahlstrom, Bjork, Arvidsson, & Thyberg, 2012 ). Patients expressed an insufficiency about diet and special dietary recommendations to reduce RA symptoms.…”

Rehabilitation for patients with rheumatic diseases: Patient experiences of a structured goal planning and tailored follow-up programme

“… 1 – 5 From the early onset of the illness, multidisciplinary rehabilitation is a valuable adjunct to medical treatment in this process. 6 , 7 Multidisciplinary rehabilitation in the context of a biopsychosocial model of illness has been shown to be beneficial for patients with rheumatic diseases. 8 – 11 However, research also shows that rehabilitation outcomes tend to be short lived.…”