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Direct healthcare resource utilisation, health-related quality of life, and work productivity in patients with moderate rheumatoid arthritis: an observational study

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James Galloway, Julie Edwards, Shweta Bhagat, Ben Parker, Ai Lyn Tan, James Maxwell, Mike Wallington, Sophee Blanthorn-Hazell, Claire Bellamy, Zoe Cole

Original languageEnglish
Article number277
Issue number1
PublishedDec 2021

Bibliographical note

Funding Information: The authors wish to acknowledge the following individuals for their contributions: Sarah Stevenson, Joanne Fletcher, Lynette Wheeler, Annette Wilkinson, Sarah Johnson: for their contribution to consenting patients and data collection (Royal Wolverhampton NHS Trust); Samana Schwank, Georgie Bird, Aderonke Audu: for their contribution to data collection (Kings College Hospital NHS Foundation Trust); Sam Carvalho: for their contribution to consenting patients, data collection and management of data queries (Salisbury NHS Foundation Trust); Leticia Garcia-Montoya: for their contribution to consenting patients and caregivers (Leeds Teaching Hospitals NHS Trust). Writing and editorial support was provided by Dr. Julia Granerod, funded by AbbVie. Funding Information: This observational study was initiated, organised and fully funded by AbbVie. AbbVie participated in study design, interpretation of data, review and approval of this manuscript. AbbVie commissioned and funded OPEN VIE, a healthcare research consultancy company, to provide project design, project management, data analytics, and medical writing support. Publisher Copyright: © 2021, The Author(s). Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

King's Authors


Background: The aim was to describe the population of patients with moderate rheumatoid arthritis (RA) in the United Kingdom and the burden of disease from the perspectives of the patient, caregiver, and health service. Methods: In this descriptive study, retrospective patient-level data were extracted from hospital medical records to assess healthcare resource utilisation and validated outcome measures were administered via questionnaire to patients with moderate RA (Disease Activity Score [DAS28] between 3.2 and 5.1) from eight secondary care centres, and their caregivers. Patient-reported outcome instruments were scored according to licensed manuals. Results: Outcome measures were completed by 102 patients and 38 caregivers. The mean EuroQoL-5 dimension-5 level crosswalk index value for patients was 0.62 (SD 0.24) compared to an England population norm of 0.82. Mean pain VAS score was 37.7 (SD 24.0) and mean Health Assessment Questionnaire Disability Index was 1.1 (SD 0.8). In employed patients who completed the Work Productivity and Activity Impairment questionnaire (n = 26), a mean 29% (SD 26%) reduction in work productivity was recorded. Patients experienced significant fatigue as a result of their RA (median Functional Assessment of Chronic Illness Therapy fatigue score 17.2 of a possible 52, interquartile range [IQR] 11.0–28.8). Over 50% of caregivers reported providing > 7 h of support care per week to the patient with RA, and 16 and 11% took paid/unpaid leave or reduced working hours, respectively. Mean Caregiver Reaction Assessment subscale scores were 1.9 (SD 0.9) for finance, 1.7 (SD 0.8) for health, 2.3 (SD 1.0) for schedule disruption, and 1.9 (SD 0.8) for family support. Patients had a mean 5.5 (SD 4.1) outpatient attendances and a median 9.0 (IQR 2.0–20.0) diagnostic and monitoring tests in the 12 months prior to enrolment. Conclusions: This study shows that moderate RA has a considerable impact on healthcare resources and on patients’ and caregivers’ lives. There is scope to improve the management of patients with moderate RA.

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