Abstract：
BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with chronic pain that gradually becomes incapacitating and negatively influences the health-related quality of life (HRQoL). This study estimates HRQoL in RA using the EuroQol five dimensions (EQ-5D) tool and its association with functional status and disease activity.
METHODS: RA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ-5D-5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ-VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score-28 (DAS-28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson\'s correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05.
RESULTS: The EQ-5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ-VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS-28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ-5D scores for RA patients were 0.78 (0.65-0.90) for no disease activity, 0.73 (0.65-0.80) for mild, 0.53 (0.32-0.74) for moderate and 0.47 (0.32-0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ-5D.
CONCLUSIONS: RA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study\'s EQ-5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.
METHODS: RA patients (n = 320) aged above 18 years, visiting outpatient clinic at a tertiary care multispecialty hospital in south India were the study participants. Sociodemographic, clinical, and laboratory data were collected from them. EQ-5D-5L questionnaire and the EQ Global Health Visual Analogue Scale (EQ-VAS) were used to measure HRQoL. Disease activity was measured using Disease Activity Score-28 (DAS-28), and the Health Assessment Questionnaire (HAQ) was used to assess functional status. Pearson\'s correlation and multiple linear regression were used to measure association, and statistical significance was considered at p < 0.05.
RESULTS: The EQ-5D utility score was 0.54 ± 0.36, pain and anxiety were the most affected domains, and the mean EQ-VAS was 63.05 ± 18.54%. A moderate to high disease activity was present in 85% (DAS-28 > 3.2), and a severe functional disability in 32.8% (HAQ > 1.5) of study participants. The mean EQ-5D scores for RA patients were 0.78 (0.65-0.90) for no disease activity, 0.73 (0.65-0.80) for mild, 0.53 (0.32-0.74) for moderate and 0.47 (0.32-0.62) for high disease activity. In multiple linear regression analysis, HAQ and age independently predicted EQ-5D.
CONCLUSIONS: RA significantly impacts HRQoL, and interventions focussing on pain and anxiety management are essential. The study\'s EQ-5D values could help estimate Quality Adjusted Life Years (QALY) while conducting economic evaluation studies in RA within an Indian context.
摘要：
背景：类风湿性关节炎（RA）是一种自身免疫性疾病，伴有慢性疼痛，逐渐丧失功能并对健康相关生活质量（HRQoL）产生负面影响。本研究使用EuroQol五维度（EQ-5D）工具估计RA的HRQoL及其与功能状态和疾病活动的关联。
方法：RA患者（n=320），年龄在18岁以上，研究参与者在印度南部一家三级护理多专科医院门诊就诊.社会人口统计学，临床,并从他们那里收集了实验室数据。使用EQ-5D-5L问卷和EQ全球健康视觉模拟量表（EQ-VAS）测量HRQoL。使用疾病活动评分28（DAS-28）测量疾病活动，健康评估问卷（HAQ）用于评估功能状态。皮尔逊相关和多元线性回归用于测量关联，在p<0.05时认为有统计学意义。
结果：EQ-5D效用评分为0.54±0.36，疼痛和焦虑是受影响最大的领域，平均EQ-VAS为63.05±18.54%。85％的患者出现中度至高度疾病活动（DAS-28>3.2），32.8%(HAQ>1.5)的研究参与者出现严重的功能障碍。RA患者无疾病活动的平均EQ-5D评分为0.78（0.65-0.90），轻度为0.73（0.65-0.80），中度为0.53（0.32-0.74），高疾病活动度为0.47（0.32-0.62）。在多元线性回归分析中，HAQ和年龄独立预测EQ-5D。
结论：RA显著影响HRQoL，以疼痛和焦虑管理为重点的干预措施至关重要.该研究的EQ-5D值可以帮助估计质量调整寿命年（QALY），同时在印度背景下进行RA的经济评估研究。
方法：RA患者（n=320），年龄在18岁以上，研究参与者在印度南部一家三级护理多专科医院门诊就诊.社会人口统计学，临床,并从他们那里收集了实验室数据。使用EQ-5D-5L问卷和EQ全球健康视觉模拟量表（EQ-VAS）测量HRQoL。使用疾病活动评分28（DAS-28）测量疾病活动，健康评估问卷（HAQ）用于评估功能状态。皮尔逊相关和多元线性回归用于测量关联，在p<0.05时认为有统计学意义。
结果：EQ-5D效用评分为0.54±0.36，疼痛和焦虑是受影响最大的领域，平均EQ-VAS为63.05±18.54%。85％的患者出现中度至高度疾病活动（DAS-28>3.2），32.8%(HAQ>1.5)的研究参与者出现严重的功能障碍。RA患者无疾病活动的平均EQ-5D评分为0.78（0.65-0.90），轻度为0.73（0.65-0.80），中度为0.53（0.32-0.74），高疾病活动度为0.47（0.32-0.62）。在多元线性回归分析中，HAQ和年龄独立预测EQ-5D。
结论：RA显著影响HRQoL，以疼痛和焦虑管理为重点的干预措施至关重要.该研究的EQ-5D值可以帮助估计质量调整寿命年（QALY），同时在印度背景下进行RA的经济评估研究。
