Who are the patients with early arthritis with worse than death scores on the EQ-5D? Results from the ESPOIR cohort.

Abstract : OBJECTIVES: The EQ-5D is a five-dimension multi-attribute questionnaire widely used to calculate quality-adjusted life-year scores. We aimed to describe patients with early arthritis (EA) and EQ-5D < 0, a state worse than death, at baseline and over 2 years and determine aspects of EA associated with a negative score. METHODS: EQ-5D scores for 813 patients were longitudinally assessed over 24 months. Characteristics and health status of patients with EQ-5D < 0 were analysed. Multivariate logistic regression was used to determine aspects of EA associated with a negative score. RESULTS: At baseline, 90 (11%) patients had a negative EQ-5D score (median EQ-5D -0.052; range -0.530 to -0.011). Almost all patients had extreme pain/discomfort and at least moderate problems in anxiety/depression domain. These patients had lower educational level, greater disease activity, higher HAQ score (greater functional disability), greater pain and fatigue, lower Short Form 36 (SF-36) mental component scores and higher CRP levels than patients with EQ-5D ≥ 0 (all P < 0.001). In the logistic regression model, worse HAQ and SF-36 mental component scores were associated with EQ-5D < 0. Results were similar at 6, 12 and 24 months, with 25, 23 and 24 patients, respectively, in a state worse than death. CONCLUSION: Pain or discomfort, often severe, is a key domain of the EQ-5D for patients with EA in a health state worse than death, and poor HAQ and SF-36 mental component scores were always independently associated with a state worse than death. EA patients may have specific needs necessitating better management of pain and psychological state.
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Rheumatology, Oxford University Press (OUP), 2013, 52 (5), pp.832-8. 〈10.1093/rheumatology/kes270〉
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Soumis le : mercredi 23 juillet 2014 - 16:03:15
Dernière modification le : mardi 24 juillet 2018 - 10:16:01

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Cécile Gaujoux-Viala, Bruno Fautrel, Francis Guillemin, René-Marc Flipo, Pierre Bourgeois, et al.. Who are the patients with early arthritis with worse than death scores on the EQ-5D? Results from the ESPOIR cohort.. Rheumatology, Oxford University Press (OUP), 2013, 52 (5), pp.832-8. 〈10.1093/rheumatology/kes270〉. 〈hal-01044491〉

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