Background: Rheumatoid arthritis (RA) is a debilitating disease, which has a significant impact on patients' health related quality of life (HRQoL), and limits the physical function as well as increases pain and fatigue.
Objectives: The purposes of this study were to assess the HRQoL and functional disability profile of RA patients in Northern West-Bank, Palestine, to determine the socio-demographic and clinical characteristics associated with poor HRQoL and functional disability among RA patients, and to investigate the effect of medications used on the functional disability and HRQoL.
Methodology: a cross sectional, observational study carried out at rheumatology clinics in Northern West-Bank, Palestine (Alwatani Hospital - Nablus, Khalil Suleiman Hospital - Jenin, Thabet Thatbet Hospital- Tulkaram, and Darweesh Nazzal Hospital – Qalqilia). EuroQoL-5 Dimensions scale (EQ-5D) was used to evaluate HRQoL, Health Assessment Questionnaire Disability index (HAQ-DI) to evaluate functional disability, and the Health Assessment Questionnaire pain visual analog scales (HAQ-VAS) to evaluate pain.
Results: 300 patients were included in the study, 229(76.3%) were females, the mean ± standard deviation age was 49 ± 13.10 years, and the median RA duration (lower-upper quartiles) was 6 (4-12) years. The median EQ-5D index value and Euro QOL visual analogue scale (EQ-VAS) score was 0.56 and 60, respectively. There was a significant strong positive correlation (R = 0.773; P < 0.001) between the EQ-5D index values and the reported EQ-VAS scores. The median HAQ-DI and HAQ-VAS was 0.94 and 40, respectively. The results of multiple linear regression showed that treatment with biological DMARD (Etanercept), having a work, higher income, absence of night pain, and absence of co-morbid diseases were significantly associated with higher EQ-5D index score (better HRQoL) and lower HAQ-DI scores (less disability). On the other hand, older age and presence of morning stiffness were significantly associated with higher HAQ-DI scores (more disability).
Conclusion: This study revealed the impact of treatment, clinical variables, and sociodemographic factors on disability and HRQoL in RA patients. Healthcare providers should be aware of association between treatment with biological DMARD and improved HRQoL and functional status, in order to make early interventions that reduce disability and improve HRQoL in susceptible patients.