Clinical and sociodemographic factors determining quality of life in rheumatoid arthritis (RA)

Background. Although rheumatoid arthritis is not a curable disease and gradually leads to patient's immobility there could be an improvement in QoL through ameliorating well- being and restoration their social functioning which seems to be a strategic therapeutic goal. Identifying factors which have significant impact on QoL of RA patients might be important information when choosing the most beneficial treatment for the patient. Objectives. This study examines the factors which influences quality of life (QoL) of patients with rheumatoid arthritis (RA). The following QoL predictors were taken into account: sociodemographical, clinical factors - disease duration and severity, smoking, morning stiffness duration, BMI, DAS 28, treatment and co-morbidity. Material and methods. The study was carried out with 60 RA patients between 23 and 79 years of age hospitalized in Rheumatology Unit of Academic Clinical Hospital in Wroclaw between November 2007 and March 2008. They were diagnosed with RA based on 1987 criteria of American College of Rheumatology. The mean illness duration for 33.3% of patients in the study group was up to 5 years since having been diagnosed, 36.7% from 6 to 10 years and 21.7% with RA over 11 years. For clinical estimation of patients activity the Disease Activity Score (DAS 28) and Visual Analogue Scale (VAS) for pain were used. The QoL was assessed using key areas of self-reported health status of Health Assessment Questionnaire (HAQ) for validation of functional disability and WHOQoL-BREF questionnaire. Results. The study (n = 60) showed statistical significance (p < 0.05) between HAQ score and patients' age (r = 0.638), marital status (r = 0.548), BMI (r = 0.503), DAS 28 (r = 0.375) and illness duration (r = 0.376). There was also statistically significant dependence (p < 0.05) found between the results of WHOQoL-BREF questionnaire and age in psychological (r = 0.362), social (r = 0.416) and environmental (r = 0.304) domain as well as BMI in physical (r = 0.270), psychological (r = 0.408) and social (r = 0.371) area and a correlation with patients education in all four WHOQoL domains. Other significant correlation between WHOQoL outcome and the illness duration was found in psychological and social domain. Conclusions. The sociodemographic factors influencing QoL of RA patients include: education, marital status, age and living conditions. The clinical factors impinging on life quality are DAS 28, BMI > 30, disease duration. RA patients obtained the lowest results in social area.