Article

OBJECTIVE: To study health-related quality of life (HRQoL) in arthritis
rehabilitation performed by multidisciplinary teams in patients with chronic
inflammatory arthritis. Predictors of change in health-related quality of life
and the proportion of patients with clinical improvement were investigated.
DESIGN: Multicentre prospective observational study in 4 European countries.
METHODS: HRQoL was measured with the European Quality 5 Dimensions (EQ-5D) and
the Short Form 36 Health Survey (SF-36) in 731 patients who underwent
multidisciplinary rehabilitation. Potential predictors were physical functioning
(Health Assessment Questionnaire (HAQ)), self-efficacy (Arthritis Self Efficacy
Scale (ASES)), psychological health (Hopkins Symptom Check List (HSCL-25)),
pain/fatigue (numeric rating scales (NRS)), age, sex, diagnosis, comorbidity,
education, clinical setting and change of medication during rehabilitation.
Analysis of covariance (ANCOVA) was used to assess for potential predictors and
interactions. The minimal important differences for HRQoL were analysed. RESULTS:
Reporting worse function (b 0.05, p = 0.01), less psychological well-being (b
0.09, p = 0.000), and experiencing more pain (b 0.03, p = 0.000) or fatigue (b
0.02, p = 0.000) at admission predicted improved HRQoL. Change in medication
during rehabilitation (b 0.08,
p = 0.013) was associated with greater improvement
in HRQoL. These EQ-5D findings were supported by SF-36 findings. Positive minimal
important differences were noted in 46% (EQ-5D) and 23-47%
(SF-36 subscales) of
the patients. CONCLUSION: Patients with more severe symptoms experienced the
largest gain in HRQoL post-intervention. The results of this study are of value
for selecting the right patients for rheumatological team rehabilitation.

Langue : ANGLAIS