Kaleb Michaud, MS, Stanford University, Stanford, CA
- Purpose. Quality of life (QOL) is impaired in rheumatoid arthritis (RA), but there have been no studies comparing RA QOL with US national data.
- Methods. I evaluated 12,353 patients with RA in a long-term observational study of arthritis outcomes. Between July 2002 and January 2006, patients contributed semiannual measurements of indirect QOL utilities, including the EQ5D (US & UK scoring), EQ-VAS and SF-6D; a 1,355 patient-subset completed the HUI3 in January 2003. Coons et al (in preparation) provided national EQ5D-US values for comparison. QOL measures were also adjusted to US-norms in ethnicity, income, marital status and education. Fixed effects (FE) models with overlapping age splines measured within-patient change over time and accounted for changes in QOL that controlled for participation bias and survivor effect.
- Results. Mean (SD) characteristics of RA subjects were: age 62.2 (13.1) years, male 21.4%, non-Hispanic white 92.8%, education 13.7 (2.3) years and HAQ 1.03 (0.71). Unadjusted QOL utilities were EQ5D-US 0.743 (0.173), EQ5D-UK 0.653 (0.256), SF-6D 0.626 (0.087), EQ-VAS 0.678
(0.177) and HUI3 0.657 (0.246). The mean EQ5D-US QOL in RA increased slightly over age in contrast to the US mean, but the FE showed a similar to US data QOL by age relationship until post-retirement with increased worsening in RA. While the average male QOL with RA was greater than the female (0.723 vs 0.707), the FE curve showed there is a much greater QOL decline in males over time. Adjusted EQ5D-US for RA was 0.709, 0.163 lower than US average of 0.872. The EQ5D-US correlated with the HAQ (r=-0.66), increased on average (SD) by 0.030 (0.133) for a 6-month 0.25-unit improvement in HAQ and ranged from 0.894 (0.100) at 0-0.125 HAQ to 0.332 (0.221) at 2.75-3.0 HAQ. - Conclusions. Lifetime QOL in RA parallels US-norms but is consistently and significantly reduced. The HAQ can be an approximate utility measure in effectiveness analyses.
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See more of The 28th Annual Meeting of the Society for Medical Decision Making (October 15-18, 2006)
