Targeting unmet needs could improve QoL in early RA
medwireNews: Socioeconomic deprivation and mental health problems have been identified as significant and independent predictors of poor health-related quality of life (HRQoL) among people with early rheumatoid arthritis (RA) managed using treat-to-target strategies.
The study, reported in a poster presentation at the ACR Convergence 2021 virtual meeting, included 1069 people with newly diagnosed RA or undifferentiated arthritis who were enrolled in the Scottish Early Rheumatoid Arthritis cohort between 2011 and 2015 and followed up for 1 year.
Claire Wood (NHS Greater Glasgow and Clyde, UK) reported that HRQoL as measured by the EuroQoL 5-dimension (EQ-5D) 3-level questionnaire improved significantly when participants were treated in routine care according to treat-to-target strategies, with the greatest improvement seen in the first 6 months of follow-up.
Specifically, average EQ-5D time trade-off scores improved from 0.49 points at baseline to 0.67 points at 6 months, with a further improvement to 0.70 points at 1 year. Wood noted that all dimensions of the score – mobility, anxiety, pain, activity, and care – improved over the follow-up period.
However, she said that despite these improvements, people with the worst HRQoL at 1 year still had “substantial unmet need.” Those in the lowest quartile for EQ-5D scores at 1 year had significantly higher mean SDAI (20.1 vs 7.6) and HAQ disability (1.58 vs 0.46) scores than those in the other quartiles, and were significantly more likely to have anxiety (49 vs 11%) or depression (41 vs 4%).
Looking at baseline factors, the team found that people in the lowest quartile for EQ-5D scores at 1 year were significantly more likely than those in the other quartiles to live in deprived neighborhoods (36 vs 14%) and have anxiety (49 vs 21%) or depression (42 vs 12%) at baseline. Moreover, these factors were all significant independent predictors of poor HRQoL on multivariable analysis, as were baseline HRQoL and employment status.
“Psychological ill health and the impact of social deprivation are potentially modifiable, and we conclude that research is needed into the efficacy of strategies such a psychological support aiming to mitigate the negative impact of these factors on health-related quality of life,” concluded Wood.
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