Disability and health-related quality of life among patients with rheumatoid arthritis: association with radiographic joint damage, disease activity, pain, and depressive symptoms

Objective: To study the associations between disability and health-related quality of life ( HRQoL), respectively, and radiographic joint damage, disease activity, pain, and depressive symptoms among patients with rheumatoid arthritis ( RA). Methods: Data were collected through questionnaires and clinical examinations at baseline ( 1997) and at 2 years' follow-up among patients with RA ( n=5307). Disability was measured with a validated Dutch questionnaire, derived from the Health Assessment Questionnaire ( HAQ), and HRQoL with a validated Dutch version of the RAND-36, using physical ( PCS) and mental ( MCS) component summary scales. Multivariate linear regression analyses were performed to assess the relationship between disability or HRQoL and radiographic damage, disease activity, pain, and depressive symptoms. Results: Pain, with respect to disability and PCS, and depressive symptoms, with respect to MCS, were more important predictors than radiographic damage and disease activity. Conclusions: Daily RA practice needs to be broadened by regular assessment of disease burden from the patients' perspectives. Patient-reported measures, such as disability or HRQoL, should be incorporated for monitoring health outcomes of individual patients and for initiating and evaluating therapy.