Background Early diagnosis of rheumatoid arthritis (RA) and appropriate treatment are the conditions, that slow process of a long-term disease leading to disability. As a consequence, the RA prevents the normal functioning and daily activities of affected families.
Objectives To find correlation between time to diagnosis, duration of RA and quality of life.
Methods Questions on quality of live (QOL) were a part of questionnaire used in a research of costs of RA. From November 2009 to March 2010, 1000 questionnaires were completed by people with diagnosed RA, living in different parts of Poland and being patients of rheumatological centers. Health Assessment Questionnaire (HAQ) was an attachment to main questionnaire. Other questionnaire was completed by rheumatologists and provided the information on treatment administered and stage of disease.
Comparison of data obtained from those questionnaires presents an impact of RA on everyday life.
Results Women comprise the majority of respondents (83%). Median age of all respondents was 60 years and median duration of disease was 13 years. 53% of respondents have certificate of disability. Average respondent needs daily up to 3 hours help of third party.
Half of the respondents has experienced first symptoms of RA between 40 and 60 years, whereas peak of disease (27%) is observed in patients aged 40-50 years. 1/5 of patients with RA is diagnosed being 30-40 years old.
63% of respondents were diagnosed nearly one year after first symptoms. The observed differences in time from first symptoms to diagnosis were related to place of residences of the patient (region and size of place). Surprisingly, 66% of people living in rural area (with limited access to rheumatologist) and 57% of people living in big cities, were diagnosed within first year since the occurrence of first symptoms of RA. About 8% of respondents declared that they had been diagnosed after 10 years and more from the occurrence of first symptoms of RA.
The correlation between time to diagnosis and level of disability was not found. Median HAQ is 0,60. HAQ of 65% of respondents was lower than 1 – it means that they didn’t have difficulties in everyday lives. HAQ of only 5% of respondents was equal or higher than 2,25, which reflects high level of disability. No differences in assessment of activities by respondents were observed – there were only differences in level of difficulties. Three most difficult activities for people living with RA, based on HAQ are: opening jar, doing chores and taking a bath. Some differences related to difficulties in performance of activities were connected with gender of respondents. These differences may be related to the traditional roles in the family.
Respondents with certificate of disability were those who were younger at the time RA diagnosis as compared to other people.
Conclusions Majority of respondents (63%) were diagnosed within one year from first symptoms of RA. Inhabitants of rural area are diagnosed earlier then inhabitants of big cities. Men were diagnosed earlier than women. Respondents with first symptoms in younger age were diagnosed later than older people – significant disability is more frequent among younger people with RA.
The same every day activities are difficult for people living with RA, but the difference exist in level of difficulties – people with higher level of disability have bigger difficulties.
No connection between time to diagnosis and level of disability was observed.
Disclosure of Interest J. Grygielska Grant/Research support from: Sanofi-Aventis