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. 2022 Sep 2;6(3):rkac071.
doi: 10.1093/rap/rkac071. eCollection 2022.

Quality of life, disease activity and preferences for administration routes in rheumatoid arthritis: a multicentre, prospective, observational study

Haner Direskeneli  1 , Omer Karadag  2 , Askin Ates  3 , Abdurrahman Tufan  4 , Nevsun Inanc  1 , Serdar S Koca  5 , Gozde Y Cetin  6 , Servet Akar  7 , Muhammet Cinar  8 , Sedat Yilmaz  8 , Neslihan Yilmaz  9 , Ediz Dalkilic  10 , Cemal Bes  11 , Baris Yilmazer  12 , Ali Sahin  13 , Duygu Ersözlü  14 , Mehmet E Tezcan  15 , Nesrin Sen  15 , Gokhan Keser  16 , Umut Kalyoncu  2 , Berkan Armagan  2 , Basak Hacibedel  17 , Kerem Helvacioglu  17 , Teoman Y Cesur  17 , Canberk S Basibuyuk  17 , Serdar Alkan  17 , Levent Mert Gunay  17
Affiliations

Quality of life, disease activity and preferences for administration routes in rheumatoid arthritis: a multicentre, prospective, observational study

Haner Direskeneli et al. Rheumatol Adv Pract. .

Abstract

Objective: We aimed to evaluate quality of life (QoL), disease activity, compliance to treatment, patient and physician preferences for route of administration (RoA), status of health and pain in RA patients starting advanced treatments or needing a switch, and the factors associated with patient preferences.

Methods: A multicentre, prospective, observational and 1-year follow-up study was conducted, between 2015 and 2020, in adult RA patients using advanced treatments for the first time or needing a switch in their current treatments. All the data collected were entered into electronic case report forms. DAS in 28 joints with ESR [DAS28-4(ESR)], EuroQol 5-Dimensional Questionnaire (EQ-5D), HAQ Disability Index (HAQ-DI), Compliance Questionnaire for Rheumatology (CQR-19), Work Productivity and Activity Impairment Instrument (WPAI) and Patient Global Assessment-Visual Analogue Scale (PGA-VAS) questionnaires were used for longitudinal assessments.

Results: Four hundred and fifty-nine patients were enrolled. Three hundred and eight patients (67.1%) attended the final study visit at 12 months and were included for comparative analyses. Irrespective of RoA, the disease activity and QoL improved significantly at 12 months, whereas compliance worsened. At baseline and 12 months, EQ-5D and DAS28-4(ESR) scores were significantly correlated (P < 0.001). The WPAI scores changed significantly in favour of better outcomes over 12 months after initiation of advanced treatment or switching (P < 0.001). A higher proportion of patients preferred an oral RoA, in comparison to physicians (53.6% vs 31.4%; P < 0.001). Patient and physician RoA preferences were independent of gender, age, disease duration, advanced treatment type and the EQ-5D-3L, DAS28-4(ESR), HAQ-DI, PGA-VAS and CQR-19 scores at baseline.

Conclusion: The oral route was more frequently preferred by patients compared with physicians, although patients' preference rates showed a slight increase towards the end of the treatment, which might be an important factor for RA outcomes. Better control of disease activity and QoL were achieved at 12 months, regardless of RoA.

Keywords: DAS; ESR; RA; advanced treatment; patient preference; quality of life; switch.

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Figures

Figure 1.
Figure 1.
EuroQol 5-Dimensional Questionnaire patient responses per domain. EQ-5D-3L patient responses at (A) baseline (n = 459) and (B) 12 months (n = 308). EQ-5D-3L: EuroQol 5-Dimensional Questionnaire
Figure 2.
Figure 2.
Correlation curve between EuroQol 5-Dimensional Questionnaire and DAS in 28 joints with ESR scores at baseline and at 12 months. EQ-5D-3L: EuroQol 5-Dimensional Questionnaire; DAS28-4(ESR): DAS in 28 joints with ESR
See this image and copyright information in PMC

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