Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects joints with some extraarticular involvement. If inappropriately treated, it usually results in persistent joint pain, irreversible deformities, and functional disability, leading to poor quality of life. Our objective was to evaluate health-related quality of life (HRQoL) and related factors in patients with RA. Four hundred sixty-four patients from the Rheumatoid Arthritis registries of Siriraj and Phramongkutklao teaching hospitals were enrolled. Sociodemographic, clinical and laboratory data related to disease activity, and functional status were collected. HRQoL was assessed using the Thai version of EuroQol five dimensional questionnaire (EQ-5D) and EQ global health visual analogue scale (EQ VAS). Univariate and multivariate analyses were employed to identify factors related to HRQoL. Eighty-five percent were female with a mean age ± SD of 59.15 ± 11.43 years and a mean disease duration ± SD of 11.53 ± 8.3 years. The mean educational level ± SD was 9.42 ± 5.21 years. Almost half were unemployed or retired (47%). They had moderate disease activity (mean cumulative DAS28 ± SD, 3.5 ± 0.8) and mild functional impairment (mean HAQ ± SD, 0.70 ± 0.68). The mean EQ-5D ± SD (0–1) was 0.87 ± 0.13 and mean EQ VAS ± SD (0–10) was 7.94 ± 1.7. Based on the EQ-5D domain, 49% reported that they had no problem with mobility, 83% had no difficulties with self-care, 65% had no difficulties with usual activity, 30% had no pain or discomfort, and 61% had no depression or anxiety. The relationship between problems of each dimension in EQ-5D significantly increased according to severity of RA assessed by the Disease Activity Score (DAS) 28 and Health Assessment Questionnaire (HAQ) (p < 0.01). In multivariate analyses, high cumulative disease activity, functional disability, depression, and anxiety were negatively associated with EQ-5D (adjusted R2 0.38, p < 0.001) and EQ VAS (adjusted R 2 0.19, p < 0.001). Disease severity and psychological disturbance have a negative impact on quality of life in patients with RA. These factors should be considered in management of RA patients to improve the standard of care.

中文翻译：

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类风湿关节炎患者的健康相关生活质量

类风湿性关节炎 (RA) 是一种慢性全身性自身免疫性疾病，主要影响关节，并伴有一些关节外受累。如果治疗不当，通常会导致持续的关节疼痛、不可逆转的畸形和功能障碍，从而导致生活质量下降。我们的目标是评估 RA 患者的健康相关生活质量 (HRQoL) 和相关因素。来自 Siriraj 和 Phramongkutklao 教学医院的类风湿关节炎登记处的 464 名患者入组。收集了与疾病活动和功能状态相关的社会人口统计学、临床和实验室数据。HRQoL 使用泰语版 EuroQol 五维问卷 (EQ-5D) 和 EQ 全球健康视觉模拟量表 (EQ VAS) 进行评估。采用单变量和多变量分析来确定与 HRQoL 相关的因素。85% 为女性，平均年龄 ± SD 为 59.15 ± 11.43 岁，平均病程 ± SD 为 11.53 ± 8.3 年。平均教育水平 ± SD 为 9.42 ± 5.21 岁。近一半失业或退休（47%）。他们有中度疾病活动（平均累积 DAS28 ± SD，3.5 ± 0.8）和轻度功能障碍（平均 HAQ ± SD，0.70 ± 0.68）。平均 EQ-5D ± SD (0-1) 为 0.87 ± 0.13，平均 EQ VAS ± SD (0-10) 为 7.94 ± 1.7。根据 EQ-5D 领域，49% 的人表示他们的行动没有问题，83% 的人没有自理困难，65% 的人在日常活动中没有困难，30% 的人没有疼痛或不适，61% 的人有没有抑郁或焦虑。根据疾病活动评分 (DAS) 28 和健康评估问卷 (HAQ) 评估的 RA 严重程度，EQ-5D 各维度问题之间的关系显着增加 (p < 0.01)。在多变量分析中，高累积疾病活动、功能障碍、抑郁和焦虑与 EQ-5D（调整后的 R2 0.38，p < 0.001）和 EQ VAS（调整后的 R2 0.19，p < 0.001）呈负相关。疾病严重程度和心理障碍对 RA 患者的生活质量有负面影响。在 RA 患者的管理中应考虑这些因素以提高护理标准。功能障碍、抑郁和焦虑与 EQ-5D（调整后的 R2 0.38，p < 0.001）和 EQ VAS（调整后的 R2 0.19，p < 0.001）呈负相关。疾病严重程度和心理障碍对 RA 患者的生活质量有负面影响。在 RA 患者的管理中应考虑这些因素以提高护理标准。功能障碍、抑郁和焦虑与 EQ-5D（调整后的 R2 0.38，p < 0.001）和 EQ VAS（调整后的 R2 0.19，p < 0.001）呈负相关。疾病严重程度和心理障碍对 RA 患者的生活质量有负面影响。在 RA 患者的管理中应考虑这些因素以提高护理标准。