EXTENDED REPORT

Seven year changes in health status and priorities for improvement of health in patients with rheumatoid arthritis

T Heiberg¹, A Finset², T Uhlig², T K Kvien³

¹ Department of Administration, Ulleval University Hospital, Oslo, Norway
² National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
³ Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway

Correspondence to:
Correspondence to:
T Heiberg
MSN, Department of Administration, Ullevål University Hospital, N-0407 Oslo, Norway; turid.heiberg{at}ulleval.no

Objectives: To examine possible changes in priorities for improvement in health and health status from 1994 to 2001 within the setting of the Oslo Rheumatoid Arthritis (RA) Register, which provides representative data for the entire RA population in the county.

Methods: All living patients in the Oslo RA Register area received a postal questionnaire in 1994 and 2001, including the Arthritis Impact Measurement Scales 2 (AIMS2), Short Form-36, the modified Health Assessment Questionnaire, and pain and fatigue visual analogue scales (VAS). Priorities for improvement in health were examined through question 60 in AIMS2, where patients are asked to indicate three of 12 areas of health where they would most like to see improvement.

Results: The number of respondents aged 20–79 years in 1994/2001 was 932/830, with similar demographic characteristics (78.8/78.3% were female, mean age 60.6/60.8, and disease duration 12.6/13.9 years). Health status was improved in all dimensions, with statistical improvement for the physical dimension, global health and pain, from 1994 to 2001. The profile of priorities remained mostly unchanged. Improvement in pain had the highest priority in both cohorts. Both symptom modifying and disease modifying drugs were more extensively used in 2001.

Conclusions: Health status had improved from 1994 to 2001, probably because of access to better and more aggressive treatments. Pain remained the area of highest priority for improvement among patients with RA—despite an improved level of pain in 2001.

Abbreviations: AIMS2, Arthritis Impact Measurement Scales 2; CI, confidence interval; DMARDs, disease modifying antirheumatic drugs; MHAQ, modified Health Assessment Questionnaire; NSAIDs, non-steroidal anti-inflammatory drugs; RA, rheumatoid arthritis; SF-36, Short Form-36; TNF, tumour necrosis factor; VAS, visual analogue scale

Keywords: patient perspective; priority; health status; pain; rheumatoid arthritis

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