Background There is sometimes a discrepancy between improved disease activity and patient satisfaction in patients with rheumatoid arthritis (RA). The correlation of patient satisfaction and disease activity, psychological state and health status are not well evaluated.
Objectives We evaluated which factor is correlated with patient satisfaction in patients with RA.
Methods Patients with RA who obtained informed consent were selected for this study. Disease activity was evaluated with swollen joint count (SJC) and tender joint count (TJC), patient global assessment (PGA) and evaluator global assessment (EGA). Anxiety and depression were examined utilizing the State-Trait Anxiety Inventory (STAI) and the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Patient satisfaction and health status were assessed using patient satisfaction scores and the 5 scores of Arthritis Impact Measurement Scale-2 (AIMS-2). Data analyses were performed utilizing Spearman correlation analysis.
Results 112 patients with RA were recruited. Average of age, disease duration and CDAI were 54.8 years old, 11.4 year and 8.8, respectively. There were no statistically significant correlations between patient satisfaction and age (r=0.1309, p=0.1690) or disease duration (r=0.1360, p=0.1528).
With regards to disease activity, patient satisfaction showed the highest correlation to PGA (r=0.603, p<0.0001), followed by TJC (r=0.4585, p<0.0001). Patient satisfaction showed a lower correlation with EGA (r=0.3807, p<0.0001) and SJC (r=0.2041, p=0.0309).
When it comes to measures of depression, patient satisfaction was moderately correlated to CES-D (r=0.4357, p<0.0001). Similarly, with anxiety, patient satisfaction was moderately correlated to STAI (State) (r=0.4419, p<0.0001), while there was no statistically significant correlation between patient satisfaction and STAI (Trait) (r=-0.1465, p=0.1231).
The correlation of patient satisfaction to the 5-AIMS-2 scores ranked as follows (from highest to lowest): role (r=0.7081, p<0.0001), affect (r=0.6916, p<0.0001), physical score (r=0.6695, p<0.0001), symptoms (r=0.6259, p<0.0001) and social function (r=0.3624, p<0.0001).
Conclusions These results indicate that patient satisfaction is correlated with role, psychological states, physical score, pain and PGA, which is reported to be related to psychological state  and pain . To improve patient satisfaction, it is important not only to reduce pain and improve physical function, but also to set patient's appropriate role and improve psychological state. Nurses' supports are expected to assist patients to improve patient satisfaction.
Fusama M, et al. Mod Rheumatol in press.
Studenic P, et al. Arthritis Rheum. 2012; 64: 2814-23.
Disclosure of Interest None declared
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