Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Patient Preference of Disability in Rheumatoid Arthritis.
Munters1, Li Alemo, Brodin2, Nina, Lofberg2, Elin, Strat2, Sara, Alexanderson3, Helene
Rheumatology Unit,, Karolinska University Hospital in Solna, Karolinska Institutet, Stockholm, Sweden
Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
Karolinska Institutet, Stockholm, Sweden
Rheumatoid Arthritis (RA) affects the individual on many levels: impairment, activity limitation/ participation restriction and health related quality of life. Patient reported outcomes (PRO:s) have been recommended to be used in RA. The predefined PRO: s have not been as responsive or sensitive to pharmacological or exercise interventions as a patient preference outcome such as the McMaster Toronto Arthritis patient preference disability questionnaire (MACTAR). The aim was to investigate disabilities most important to improve in RA patients in Sweden by using the MACTAR and to compare the self selected disabilities to items in predefined measures for RA. Further aims were to categorize the identified disabilities using the International Classification of Functioning (ICF), to correlate the MACTAR to RA core set measures, and to evaluate test-retest reliability of the MACTAR over one week.
Forty-five RA patients attending rheumatologists at the Rheumatology Clinic, Danderyd Hospital, Stockholm, Sweden, during a 6 month period were included. They had a median (md) age of 59 years (Q1-Q3) 5265 and diagnosis duration of md 10 years (421). They were assessed regarding disease activity (Disease Activity Score, DAS-28), lower and upper limb function (Timed Stands Test, TST, and Shoulder Function Assessment, SFA), pain (VAS), activity limitation (Health Assessment Questionnaire, HAQ) and Patient Global assessment of well-being (PGA) and patient preference (MACTAR), which was assessed twice within a week.
The most important disabilities to improve were fatigue in relation to social life (n=26), walking (n=21) and sleep (n=19). Fourty-seven percent of the identified disablilities were represented in items of the Comprehensive ICF core-set for RA and 53% in the HAQ. All except one of the identified disabilities were categorized into the ICF activities and participation component. Correlations between the MACTAR were rs-0.65 to the DAS 28, rs-0.61 to pain, rs-0.61 to the PGA, rs-0.51 to the HAQ, rs 0.38 to the SFA, and rs-0.19 to the TST. Test-retest analysis with Weighted Kappa koefficient (Kw) and Intra class correlation coefficient were 0.59 and 0.82 respectively with no systematic differences (sign-test, p=0.22).
The MACTAR identified fatigue in relation to social activities, walking and sleep as the disabilities most important to improve for RA patients in Sweden. Moderate to low correlations were revealed between the MACTAR and RA core set measures. The MACTAR has very good test-retest reliability and could be considered as assessing disabilities important to the patient not covered by recommended RA outcomes.
To cite this abstract, please use the following information:
Munters, Li Alemo, Brodin, Nina, Lofberg, Elin, Strat, Sara, Alexanderson, Helene; Patient Preference of Disability in Rheumatoid Arthritis. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :2424