The effects of treatment on quality of life in rheumatoid arthritis

Abstract

Aims: To assess and evaluate the impact of different pharmacological treatments on health-related quality of life in rheumatoid arthritis patients. Methods: The study was divided into two main phases. During phase 1 rheumatoid arthritis patients were recruited and administered the following health-related quality of life questionnaires: Short Form Health Survey-36 (SF-36) and Health Assessment Questionnaire – Disability Index (HAQ-DI). After six months of therapy (phase 2), the patients were re-administered both questionnaires. Data compiled from phase 1 and phase 2 questionnaires were analysed using SPSS version 17.0. The results of the questionnaires were correlated to various drug therapy regimens, to identify the best treatment that improves quality of life. Results: Seventy-five rheumatoid arthritis patients agreed to participate in the study. The mean score obtained for the HAQ in phase 2 was significantly lower than the mean score obtained for phase 1 (+/-0.804;0.05) indicating an improvement in disease state. The mean scores for the following SF-36 domains – physical functioning, physical and bodily pain - during phase 2 were significantly lower than the mean scores obtained for phase 1 (+/-0.804;0.05). The mean Disability Index score obtained in Phase 2 was lower than the mean score obtained for Phase 1 indicating a significant improvement in disability (+/- 0.804;0.05). On comparing the disability index to the specific pharmacological treatment groups, the lowest scores for disability were identified among rheumatoid arthritis patients treated with triple therapy, quadruple therapy and methotrexate (MTX) in combination with glucocorticoids. Conclusions: After 6 months of therapy, there was an overall improvement in disability, physical functioning, bodily pain and in the emotional factor. The following treatment combinations were found to be more effective in improving rheumatoid arthritis patient’s health-related quality of life: Methotrexate in combination with glucocorticoids and Triple Therapy and Quadruple Therapy.