Health-related quality of life measurements and studies in rheumatoid arthritis

Background: Rheumatoid arthritis (RA) is a major cause of disability and impairment of health-related quality of life (HRQOL) in the United States. Increasingly, HRQOL assessments are becoming part of a package of materials reviewed by managed care providers in making formulary and reimbursement decisions. Objective: To help managed care administrators understand how to interpret and apply the results of HRQOL assessment scales. Methods: Several patient-reported instruments in common use in RA were reviewed, including the Health Assessment Questionnaire (HAQ), Modified HAQ, Arthritis Impact Measurement Scale, and the 36-item Short-Form Health Survey. Results: These self-assessment scales help improve patient/physician communication and thus enable better treatment decision-making. The scales tan. also aid managed care administrators in evaluating the efficacy and the financial benefits of therapies. The HAQ was one scale that stood out as being short, easy to administer, and disease-specific for RA. Conclusions: Self-assessment reports, such as the HAQ, provide key data on disability and HRQOL from the patient's perspective. The information, so gained enables the clinician to select the most cost-effective therapies and interventions that slow disease progression, maintain functional status, and improve HRQOL.