Aproximación de discapacidad en artritis reumatoide. Resultados de un programa de atención integral

Abstract

IntroductionAlthough rheumatoid arthritis care models consider a symptomatic approach and intervention of disability, it is also important to have a model that integrates advances in the pharmacological management, as well as non-drug treatment strategies. Materials and methodsA descriptive cross-sectional retrospective study was conducted that included 640 patients diagnosed with rheumatoid arthritis and in an outpatient comprehensive care program. The first assessments made by occupational therapy with a full functional evaluation including the Barthel index, Quick DASH scale, and the Health Assessment Questionnaire. The activity of the disease was calculated using DAS28. ResultsHigher HAQ scores were observed as the level of disease activity increased. There were no significant differences in the level of activity of the disease among subjects who worked and those who did not. A low correlation was found between the DAS28 and the Quick DASH in 2evaluation modules (r=.399 for instrumental and r=.291 for the work module) (P<.005). Of the 350 subjects, 66.7% had some degree of disease activity and the percentage of patients shown to have a moderate to severe limitation in the functioning of the upper limb was 66.1% for the work module and 84.75% for the instrumental module, showing a greater functional limitation as the level of disease activity increased. ConclusionThis study has reassessed the applying of generic scales that deal with generally functionality, within the care program.