Background Despite the importance of HAQ in assessing patient-reported functional status, it was originally developed primarily for research studies. As a result, HAQ has been critiqued for being time-consuming, not easily scored, and, thus, not contributing to decisions in routine care, and being influenced by comorbiditiesref.
Objectives To describe the correlation of individual HAQ questions with outcome measures used in Rheumatoid Arthritis (RA). To examine whether the instrument could be reduced to better reflect routine clinical practice.
Methods BioTRAC is an ongoing, prospective registry of RA, AS, or PsA patients initiating infliximab or golimumab as first biologics or after <6 months of biologic treatment. Data from RA patients treated with infliximab in 2002-2011 were used. Parameter correlation was described with the Pearson’s correlation coefficient. The impact of each question on aids/devices/help use was assessed with logistic regression. Factor analysis was used to assess the variability in HAQ score due to each question.
Results 877 RA patients with 4,180 complete HAQ assessments were included. Higher pain, patient global assessment (PtGA), tender joint count (TJC-28) and, to a lesser extent, swollen joint count (SJC-28) were associated with increased functional impairment. In correlation analysis, individual HAQ questions correlated at different extents with each outcome measure (Table). Q5B showed the lowest correlation with the patient outcomes while the questions related to “Rising” (Q2A, Q2B) showed the highest overall correlation. All individual questions were significantly associated with the use of aids/devices/help within their corresponding category with the exception of Q3B and Q8B. In factor analysis, “Dressing & Grooming” was found to account for 66.5% of the matrix variance suggesting that the ability to dress/groom alone may be the main driver of HAQ.
Conclusions Variability exists in the correlation of individual HAQ questions with patient-reported and clinical outcomes. Pain and joint tenderness are significantly associated with the individual functions of HAQ while SJC is less important. The ability to dress/groom alone was the main driver of HAQ variability which may have implications from an occupational health perspective and in the design of self-report instruments for daily activities.
AC&R 2011:63:S486-S490; The Rheumatologist. Jan 2013.
Disclosure of Interest C. Thorne: None Declared, M. Khraishi: None Declared, B. Haraoui: None Declared, J. Rodrigues: None Declared, A. Jovaisas: None Declared, D. Choquette: None Declared, S. Dixit: None Declared, D. Sholter: None Declared, P. Baer: None Declared, M. Sheriff: None Declared, E. Rampakakis Employee of: JSS Medical Research, J. S. Sampalis Employee of: JSS Medical Research, F. Nantel Employee of: Janssen, A. Lehman Employee of: Janssen, M. Shawi Employee of: Janssen, S. Otawa Employee of: Janssen
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