Berkan ARMAĞAN, İsmail DOĞAN, Kevser GÖK, Hakan APAYDIN

Romatoid Artrit Yaşam Kalitesi Ölçeklerinin Hastalık Aktivitesine Göre Değerlendirilmesi

Amaç: Romatoid artrit (RA) hastalarında yaşam kalitesini (QoL) hastalık aktivitesi dışında ağrı, yorgunluk, depresyon, anksiyete ve uyku kalitesi de etkiler. Bu çalışmada RA hastalık aktivitesi ile QoL ölçekleri arasındaki ilişkiyi değerlendirmeyi amaçladık. Yöntemler: Bu kesitsel çalışmaya, Ocak-Aralık 2020 tarihleri arasında Ankara Şehir Hastanesi Romatoloji polikliniğine başvuran, ardışık 92 RA hastası dahil edildi. Hastaların demografik verileri, klinik özellikleri ve laboratuvar sonuçları kaydedildi. Hastalık aktivitesini değerlendirmek için DAS28, QoL değerlendirmek için ise ağrı-görsel analog skoru (VAS), yorgunluk-VAS, hastane anksiyete depresyonu(HAD), Pittsburgh Uyku Kalitesi İndeksi (PSQI) ve Nottingham Sağlık Profili (NHP) ölçekleri birebir hasta vizitinde doldurulmuştur. RA hastaları hastalık aktvitesine göre “Düşük-DAS28 grubu” ve “Yüksek-DAS28” olarak olarak gruplandırıldı. Sonuçlar: Düşük-DAS28 ve Yüksek-DAS-28 gruplarının karşılaştırılmasında, ağrı-VAS, yorgunluk-VAS ve bazı NHP skorları (toplam skor ve ağrı, fiziksel aktivite ve yorgunluk alt grup skorları), Yüksek-DAS28 grubunda istatiksel anlamlı olarak daha yüksekti. Ancak HAD skorları her 2 grupta benzerdi. PSQI uyku bozukluğu altgrup skoru Yüksek-DAS28 grubunda daha yüksekti fakat PSQI total skor ve diğer alt grup skorları skorları her 2 grupta benzerdi. Toplam DAS28 skoru

Evaluation of Quality of Life Scales According to Disease Activity in Rheumatoid Arthritis

Objective: In addition to disease activity in rheumatoid arthritis patients; variables such as pain, fatigue, depression, anxiety, and sleep quality are also associated with quality of life. We aimed to evaluate the relationship between disease activity and quality of life scales in rheumatoid arthritis. Methods: In this cross-sectional study, 92 consecutive rheumatoid arthritis patients who applied to Ankara City Hospital Rheumatology outpatient clinic in January-December 2020 were included. Demographic, clinical features and laboratory data were recorded. DAS28 for disease activity and pain-visual analogue score(VAS) and fatigue-VAS, hospital anxiety-depression(HAD), Pittsburgh Sleep Quality Index (PSQI), and Nottingham Health Profile (NHP) forms for quality of life assessment were filled by one-on-one interviews. Patients were grouped according to disease activity such as: “Low-DAS28 group” and “High-DAS28 group”. Results: In comparison with DAS28, pain-VAS, and fatigue-VAS, and some NHP scores (such as the total score and pain, physical activity, and fatigue subgroup scores) were statistically significantly higher in the High-DAS28 group than the Low-DAS28 group. However, no difference was found in HAD scores. Except the sleep disorder subgroup was higher in the High-DAS28 group, total and other subgroups scores of the PSQI were similar. Conclusion: Improving the quality of life in patients with rheumatoid arthritis is one of the main objectives of treatment. A high disease activity seems to be more affecting the patients in terms of pain-VAS, fatigue-VAS, NHP totalscores and NHP-pain, NHP physical activity subgroups than otherthe quality of life scales in patients with rheumatoid arthritis.

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1.Smolen JS, Aletaha D, McInnes IB. Rheumatoid arthritis. Lancet (London, England) 2016; 388(10055): 2023-38.
2.Wildier R. Rheumatoid arthritis, epidemiology, pathology and pathogenesis. In: Schumcher RH, editor. Primer on the Rheumatic Diseases. Atlanta, GA, USA: Arthritis Foundation; 1993. pp. 86-89.
3.Prevoo ML, van 't Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis and rheumatism 1995; 38(1): 44-8.
4.Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Research in nursing & health 1990; 13(4): 227-36.
5.Zigmond AS, Snaith RP. The hospital anxiety and depression scale. Acta psychiatrica Scandinavica 1983; 67(6): 361-70.
6.Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists.The Journal of the Royal College of General Practitioners 1985; 35(273):85-8
7.Kücükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasil T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. International journal of rehabilitation research Internationale Zeitschrift fur Rehabilitationsforschung Revue internationale de recherches de readaptation 2000; 23(1):31-8.
8.Buysse DJ, Reynolds CF, 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry research 1989; 28(2): 193-213.
9.Albayrak Gezer İ, Balkarli A, Can B, Bağçaci S, Küçükşen S, Küçük A. Pain, depression levels, fatigue, sleep quality, and quality of life in elderly patients with rheumatoid arthritis. Turkish journal of medical sciences 2017; 47(3): 847-53.
10.Coskun Benlidayi I. Sleep impairment: an obstacle to achieve optimal quality of life in rheumatoid arthritis. Rheumatology international 2018; 38(12): 2183-92.
11.Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO 3rd et al. 2010 Rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis and rheumatism 2010; 62(9): 2569-81. 12. Moldofsky H.Rheumatic manifestations of sleep disorders. Current opinion in rheumatology 2010; 22(1): 59-63.
13.Gjevre JA, Taylor-Gjevre RM, Nair BV, Lim HJ. Do sleepy rheumatoid arthritis patients have a sleep disorder? Musculoskeletal care 2012; 10(4): 187-95.
14.Kontodimopoulos N, Stamatopoulou E, Kletsas G, Kandili A. Disease activity and sleep quality in rheumatoid arthritis: a deeper look into the relationship. Expert review of pharmacoeconomics & outcomes research 2020; 20(6): 595-602.
15.Goes ACJ, Reis LAB, Silva MBG, Kahlow BS, Skare TL. Rheumatoid arthritis and sleep quality. Revista brasileira de reumatologia 2017; 57(4): 294-8.
16.Austad C, Kvien TK, Olsen IC, Uhlig T. Sleep disturbanuce in patients with rheumatoid arthritis is related to fatigue, disease activity, and other patient-reported outcomes. Scandinavian journal of rheumatology 2017; 46(2): 95-103. 17.Sariyildiz MA, Batmaz I, Bozkurt M, Bez Y, Cetincakmak MG, Yazmalar L, et al. Sleep quality in rheumatoid arthritis: relationship between the disease severity, depression, functional status and the quality of life. Journal of clinical medicine research 2014; 6(1): 44-52.
18.Son CN, Choi G, Lee SY, Lee JM, Lee TH, Jeong HJ, et al. Sleep quality in rheumatoid arthritis, and its association with disease activity in a Korean population. The Korean journal of internal medicine 2015; 30(3): 384-90. 19.Løppenthin K, Esbensen BA, Jennum P, Østergaard M, Tolver A, Thomsen T, et al. Sleep quality and correlates of poor sleep in patients with rheumatoid arthritis. Clinical rheumatology 2015; 34(12): 2029-39.
20.Grabovac I, Haider S, Berner C, Lamprecht T, Fenzl KH, Erlacher L, et al. Sleep Quality in Patients with Rheumatoid Arthritis and Associations with Pain, Disability, Disease Duration, and Activity. Journal of clinical medicine 2018; 7(10).
21.Ferrie JE, Kivimäki M, Akbaraly TN, Singh-Manoux A, Miller MA, Gimeno D, et al. Associations between change in sleep duration and inflammation: findings on C-reactive protein and interleukin 6 in the Whitehall II Study. American journal of epidemiology 2013; 178(6): 956-61.
22.Grandner MA, Sands-Lincoln MR, Pak VM, Garland SN. Sleep duration, cardiovascular disease, and proinflammatory biomarkers. Nature and science of sleep 2013; 5: 93-107.