rss
Ann Rheum Dis 2009;68:879-884 doi:10.1136/ard.2008.088708
  • Clinical and epidemiological research

Responsiveness of the International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis

  1. T Uhlig1,
  2. R Moe1,
  3. S Reinsberg1,
  4. T K Kvien1,
  5. A Cieza2,
  6. G Stucki2
  1. 1
    National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
  2. 2
    Physical Medicine and Rehabilitation, University of Munich, Munich, Germany
  1. Dr T Uhlig, National Resource Center for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Postboks 23 Vinderen, N-0319 Oslo, Norway; till.uhlig{at}diakonsyk.no
  • Accepted 5 July 2008
  • Published Online First 14 July 2008

Abstract

Background: The comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis (RA) is a selection of 96 categories from the ICF, representing relevant aspects in the functioning of patients with RA.

Objectives: To study the responsiveness of the ICF Core Set for RA in rheumatological practice.

Methods: A total of 46 patients with RA (72% women, mean (SD) age 53.6 (12.6) years, disease duration 6.3 (8.0) years) were interviewed at baseline and again after 6 months treatment with a disease-modifying antirheumatic drug (DMARD), applying the ICF Core Set for RA with qualifiers for problems on a modified three-point scale (no problem, mild/moderate, severe/complete). Patient-reported outcomes included Modified Health Assessment Questionnaire (MHAQ) and Short-Form 36 (SF-36) health survey, and disease activity was calculated. Responsiveness was measured as change in qualifiers in ICF categories, and was also compared with change in patient-reported outcomes.

Results: After 6 months of DMARD treatment, improvement by at least one qualifier was seen in 20% of patients (averaged across all ICF categories), 71% experienced no change and 9% experienced worsening symptoms. Findings were similar across the different aspects of functioning. Mainly moderate effect sizes were seen for 6-month changes in the ICF Core Set for RA, especially in patients with improved health status, with similar effect size for disease activity. The components in the ICF Core Set for RA were only weakly associated with patient-reported outcomes and disease activity.

Conclusions: The ICF Core Set for RA demonstrated moderate responsiveness in this real-life setting of patients where minor changes occurred during treatment with DMARDs.

Footnotes

  • Competing interests: TKK: Hans Bijlsma was the Handling Editor for this article.

  • Funding: This project is part of the ICF Core Sets Validation Study and was supported by a research grant from the European League Against Rheumatism (EULAR).

  • Ethics approval: The regional ethics committee approved the study.

  • ‣ Additional data (Supplementary table 1) are published online only at http://ard.bmj.com/content/vol68/issue6

This Article

  1. Abstract
  2. Full text
  3. PDF
  4. All versions of this article:
    1. ard.2008.088708v1
    2. 68/6/879 most recent

Responses

  1. Submit a response
  2. No responses published

Register for free content

The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.

Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.