Health related quality of life in rheumatoid arthritis, osteoarthritis, diabetes mellitus, end stage renal disease and geriatric subjects. Experience from a General Hospital in Mexico

Abstract

Introduction: Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases.

Objectives: The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group.

Patients and methods: We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was≥65 years, and the control group≥30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea.

Results: We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (P<.0001). The SF-36 scores were different between control group and others groups (P=0.007). The worst HRQoL was in end-stage renal disease group (±SD: 48.06±18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2±2.4) and RA (5.1±3). HAQ was higher in OA compared to RA (1.12±0.76 vs 0.82±0.82, respectively; P=.001). Forty five percent of all subjects had depression.

Conclusions: The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention.

Keywords: Artritis reumatoide; Calidad de vida relacionada con la salud; Chronic diseases; Diabetes mellitus; End-stage renal disease; Enfermedades crónicas; Geriatric subjects; Health-related quality of life; Insuficiencia renal terminal; Osteoarthritis; Osteoartritis; Población geriátrica; Rheumatoid arthritis.