Abstract
ObjectiveThis 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).MethodsThis 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.ResultsThe 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.ConclusionThe HAQ score was found to be a good predictor of the need for social support measures in patients with RA.
Highlights
As a chronic inflammatory disease, rheumatoid arthritis (RA) can lead to impairment of physical functioning and mobility, loss of productivity, and difficulties in performing normal daily activities
To limit the impact of RA on functioning and quality of life, support measures addressing activity limitations and participation issues are an important complement to the medical treatment
We investigated whether the Health Assessment Questionnaire (HAQ) can predict the need for such social support measures in patients with RA, with the expert opinion of the treating rheumatologist as a reference and compared the performance of HAQ, DAS28 and SF-36
Summary
As a chronic inflammatory disease, rheumatoid arthritis (RA) can lead to impairment of physical functioning and mobility, loss of productivity, and difficulties in performing normal daily activities. To limit the impact of RA on functioning and quality of life, support measures addressing activity limitations and participation issues are an important complement to the medical treatment. The Health Assessment Questionnaire (HAQ) was developed three decades ago at Stanford University by Fries and colleagues as a patient-reported outcome instrument designed to measure health status and health-related quality of life. It is a 20-item questionnaire covering activities of daily living in 8 domains. HAQ scores .1 are considered to indicate the presence of disability
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