Study Reminds That Health Status of Rheumatoid Arthritis Patients Can Be Measured

Repeated measures of blood sugar are taken to assess the health status of diabetics. The same is true of hypertensives regarding blood pressure. But is there a comparable measure to assess the health status of those with rheumatoid arthritis?

A study in the January issue of Arthritis & Rheumatism is a reminder that a measuring instrument exists for RA patients: the Health Assessment Questionnaire (HAQ).

Introduced 23 years ago by Dr. James Fries and his colleagues at Stanford University School of Medicine and revised in 1983 by Dr. Theodore Pincus, a professor at Vanderbilt University School of Medicine, the HAQ is a self-report questionnaire for patients that can be completed in ten minutes or less. The questionnaire is used by many rheumatology practices and in clinical research studies all over the world.

"For a long time rheumatologists have been aware of their patients' main abnormalities, which do not show up in laboratory or imaging tests, but in every day activities," study author Dr. Tuulikki Sokka, an assistant professor at Vanderbilt University, told Medical Week.

Sokka said the HAQ is better than any other measure including laboratory and imaging tests in measuring the health status of RA patients because the questionnaire is sensitive to change in a patient's functional status over time.

The HAQ contains questions about the difficulty of performing everyday activities such as dressing, bathing, getting in and out of bed, walking outdoors and doing errands, according to Sokka.

In their study, Sokka and her colleagues compared the HAQ scores of 1,095 patients with RA to the HAQ scores of 1,530 sex- and age-adjusted controls in a community in central Finland.

"We found, as expected, that patients with RA experienced much more disability in daily activities compared to the community controls," said Dr. Tuulikki Sokka, an assistant professor at Vanderbilt University. "The impact of disability due to RA appeared to be greater in younger and middle-age people than in elderly patients."

Prior studies, including those conducted by Sokka and her colleagues, have shown that the health status of RA patients can be improved by early recognition, active treatment strategies with disease-modifying agents and healthy lifestyle choices such as strengthening and aerobic exercises.

"However, without valid measures which are implemented as part of routine clinical care, improvements over time can not be detected," Sokka added.

Sokka said the health status of RA patients should be measured each time they visit the doctor. Doing so, she explained, allows for the best treatments to be tailored for each RA patient and can prevent crippling.

For RA patients whose health care professionals are not using this assessment, Sokka said they could download the questionnaire themselves at www.mdhaq.com, complete it and bring it to their doctors.

Other sources: Arthritis & Rheumatism, Vol. 48 Issue 1, pp. 59-63