Assessment of activity limitations with the health assessment questionnaire predicts the need for support measures in patients with rheumatoid arthritis: a multicenter observational study

PLoS One. 2014 Sep 4;9(9):e106749. doi: 10.1371/journal.pone.0106749. eCollection 2014.

Abstract

Objective: This study investigated whether the Health Assessment Questionnaire (HAQ) can be used as an instrument to assess the need for social support measures that address activity limitations and participation issues in patients with rheumatoid arthritis (RA).

Methods: This multicenter observational study included patients with RA and disease duration of at least one year, consulting their rheumatologist for routine evaluation of disease activity. In the single study visit data on demographics, disease history and current treatment were collected. DAS28 values were collected to evaluate current RA disease activity. Patients were asked to fill out the HAQ and SF-36 questionnaires. Receiver Operator Characteristics (ROC) curves were constructed to evaluate the performance of the HAQ, SF-36 and DAS28 in predicting the need for nine supporting measures available for chronically ill patients in the Belgian social security system. The expert opinion of the treating rheumatologist was used as a reference.

Results: The study included 316 patients with a mean age of 59.8 ± 12.6 years, disease duration of 11.4 ± 9.3 years, mean DAS28 values of 2.83 ± 1.17. Mean HAQ score was 0.95 ± 0.73, mean SF-36 score 56.5 ± 21.3. HAQ scores >1 were observed in 39.4% of patients. The area under the HAQ ROC curve was consistently >0.7 and higher for the HAQ than for SF-36 or DAS28 for all support measures. Rheumatologists on average recommended 3.67 support measures.

Conclusion: The HAQ score was found to be a good predictor of the need for social support measures in patients with RA.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Aged
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / psychology*
  • Disability Evaluation
  • Female
  • Health Services Needs and Demand / statistics & numerical data*
  • Health Status
  • Humans
  • Male
  • Middle Aged
  • Research Design
  • Severity of Illness Index
  • Surveys and Questionnaires

Grants and funding

This work was supported by an unrestricted educational grant from Roche, by the ‘Fonds de la Recherche de l'Association Polyarthrite-FRAP’ and by the ‘Fonds voor Wetenschappelijk Reuma Onderzoek/Fonds pour la Recherche Scientifique en Rhumatologie’. The funders had no role in study design, data collection and analysis,decision to publish, or preparation of the manuscript.