Background Given the high prevalence of musculoskeletal (MSK) disorders, there is a need to determine which conditions have the greatest impact on health-related quality of life (HRQoL).
Objectives To compare the HRQoL scores of the Medical Outcomes Study Short-Form 36 Health Survey (SF-36) and of the two widely used indirect utility instruments, the EuroQol Five Dimensions questionnaire (EQ-5D) and the Short-Form Six Dimensions questionnaire (SF-6D) among 14 different MSK disorders and to compare them with the results of a selecting sample of healthy controls.
Methods 2,633 patients participated to this study. MSK disorders were classified into five diagnostic groups: inflammatory rheumatic diseases (IRD), connective tissue disorders (CTD), symptomatic peripheral osteoarthritis (SPOA), soft tissue disorders (STD) and osteoporosis (OP). IRD were further classified into 3 subgroups: rheumatoid arthritis (RA) (n=572), peripheral psoriatic arthritis (PsA) (n=150) and ankylosing spondylitis (AS) (n=251). CTD were classified into sistemic sclerosis (SSc) (n=75), sistemic lupus erythematosus (SLE) (n=83) and Sjogren sindrome (SS) (n=50). SPOA included symptomatic knee (n=176), hip (n=136 patients), and hand OA (n=87). The STD group included fibromyalgia (FM) (n=226 patients), low back pain (n=141) and shoulder tendinitis/adhesive capsulitis (n=112 patients). The OP group included 172 women who had vertebral fractures due to osteoporosis, and a group of 402 asymptomatic osteoporotic women without vertebral fractures. For comparison were used 649 healthy controls. The HRQoL was evaluated with the SF-36, using physical (PCS) and mental (MCS) component scales and EQ-5D. The SF-6D utility values were calculated from SF-36 by using a definite scoring function.
Results The five major rheumatic disease groups, compared to healthy people, significantly impaired all eight health concepts of the SF-36 (p<0.0001). Similar results were found for EQ-5D, EQ-VAS and SF-6D. The patients with IRD have poorer self-reported health status than those without arthritis in all domains of living, but particularly with respect to scales measuring aspects of physical functioning or mobility, role limitation due to physical health problems and usual activities, and bodily pain. RA had the largest negative impact on HRQoL at the individual level, followed by FM, vertebral fractures due to OP, OA of the hip, and SSc.
Conclusions Our results indicates that MSK conditions have a clearly detrimental effect on the HRQoL, and physical domain is more impaired than mental and social ones. These findings may help clinical decision making and priority setting for management of individuals with MSK diseases.
Disclosure of Interest None declared
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