Rheumatoid arthritis in Lithuania: Need for external help from the onset of disease

Purpose. To estimate the burden of rheumatoid arthritis (RA) in Vilnius, Lithuania, the former socialist country in Eastern Europe, in terms of patients' need for help from other persons and to explore the factors which influence the need for physical help. Method. Some 537 patients with RA, registered in Vilnius, answered questions about socio-demographics, disease characteristics, categories of required help, the use of major appliances and adaptations, underwent a clinical examination and filled in the modified health assessment questionnaire (MHAQ) and arthritis impact measurement scale (AIMS). Logistic regression was used to assess which variables from those explored influenced the need for physical help. Results. A total of 230 (42.9%) patients out of 537 were requiring help from other persons, and the proportion was equally high in all the disease duration categories. A quarter of the patients (25.1%) were classified to ACR III and IV functional impairment groups. In multivariate logistic regression model the risk to become dependent on external help ultimately depended on MHAQ (10.32 [CI 95% 6.57-3 16.23], p < 0.001) but the use of joint stabilization measures (1.97 [CI 95% 1,06; 3.64], p < 0.01) and 28 tender joints count (1.02 [CI 95% 1.0; 1.06], p < 0.05) were also important. Conclusions. Nearly half of the patients reported being dependent on others and a quarter of patients were in definite need for that. The functional impairment is the most important risk factor, although identifying the group using joint stabilization measures routinely may be of practical value in order to define the risk group which may need the external help in future.