The impact of co-morbidity on health-related quality of life in rheumatoid arthritis and osteoarthritis patients

Abstract

Objectives: We investigated whether comorbidities differentially impacted health-related quality of life (HRQOL) for rheumatoid arthritis (RA) and osteoarthritis (OA) patients.

Methods: Adult patients with self-reported doctor-diagnosed RA (n=159) or OA (n=149) were recruited from multiple sources and completed an online cross-sectional survey. Patients self-reported sociodemographic variables, arthritis severity and comorbid conditions. HRQOL was assessed using the SF-12v2 and comorbidity counts were assigned using an expanded Functional Comorbidities Index. HRQOL (8 domain and 2 composite (physical and mental health) scores) was compared with norm-based general US population scores and between RA and OA patients to determine if they significantly differed from one another. Linear regression was used to test whether comorbidity count was associated with the physical and mental health of RA and OA patients.

Results: OA and RA patients experienced significantly worse HRQOL across all dimensions compared with that of the general US population. There were no significant differences between RA and OA patients on any HRQOL dimension. A higher comorbidity count was associated with worse physical (p=0.0007) and mental (p=0.0295) health scores when controlling for patient gender, age, education, and arthritis severity.

Conclusions: Arthritis negatively impacted patients' HRQOL. OA patients in our sample perceived their condition as similarly disabling in terms of physical and mental health as RA patients. Arthritis patients with more chronic comorbid conditions may be at particular risk for poor physical and mental health. Providers should discuss management of comorbid conditions with arthritis patients.

Fig. 1.

Norm-based health-related quality of life subscale and composite scores for RA patients (n=159), OA patients (n=149), and the 2005–2006 general US population (ages 35–89 years; n=3,844) (ref. Maglinte, 2012). PF physical functioning; RP physical role limitations; BP bodily pain; GH general health; VT vitality/energy; SF social functioning; RE emotional role limitations; MH mental health/ emotional well-being, PCS physicaal composite score; MCS mental composite

Fig. 2.

HRQOL subscales: PF physical functioning; RP physical role limitations; BP bodily pain; GH general health; VT vitality/energy; SF social functioning; RE emotional role limitations; MH mental health/ emotional well-being, PCS physical composite score; MCS mental composite. *Significant by t-test (0.05).

Fig. 3.

Summary relationship between comorbidity count and HRQOL using the SF-12v2 physical (PCS) and mental (MCS) composite scores.