Eva Hallert1, Magnus Husberg, Thomas Skogh. 1. Department of Medical and Health Sciences, Center for Medical Technology Assessment, Linköping University, Linköping, Sweden. eva.hallert@liu.se
Abstract
OBJECTIVE: To explore possible association between disease activity at 3-month follow-up after RA diagnosis and costs over the following 4 years. METHODS: Three-hundred and twenty patients with early (≤ 1 year) RA were assessed at regular intervals. Clinical and laboratory data were collected and patients reported health-care utilization and number of days lost from work. At 3-month follow-up, patients were divided into two groups according to disease activity, using DAS-28 with a cut-off level at 3.2. Direct and indirect costs and EuroQol-5D over the following 4 years were compared between the groups. Multivariate regression models were used to control for possible covariates. RESULTS: Three months after diagnosis, a DAS-28 level of ≥ 3.2 was associated with high direct and indirect costs over the following 4 years. Patients with DAS-28 ≥ 3.2 at 3-month follow-up had more visits to physician, physiotherapist, occupational therapist and nurse, higher drug costs, more days in hospital and more extensive surgery compared with patients with 3-month DAS-28 < 3.2. Number of days lost from work due to sick leave and permanent work disability was also higher in this group. The effect of disease activity on health-related quality of life was highly significant. In regression models, DAS-28 at 3-month follow-up was significantly associated with costs over the following years. CONCLUSIONS: Three months after diagnosis, DAS-28 is an important prognostic marker regarding health-care utilization and costs. Achieving remission or low disease activity 3 months after diagnosis is likely to decrease morbidity, increase quality of life and save costs for the patient and for society over the following years.
OBJECTIVE: To explore possible association between disease activity at 3-month follow-up after RA diagnosis and costs over the following 4 years. METHODS: Three-hundred and twenty patients with early (≤ 1 year) RA were assessed at regular intervals. Clinical and laboratory data were collected and patients reported health-care utilization and number of days lost from work. At 3-month follow-up, patients were divided into two groups according to disease activity, using DAS-28 with a cut-off level at 3.2. Direct and indirect costs and EuroQol-5D over the following 4 years were compared between the groups. Multivariate regression models were used to control for possible covariates. RESULTS: Three months after diagnosis, a DAS-28 level of ≥ 3.2 was associated with high direct and indirect costs over the following 4 years. Patients with DAS-28 ≥ 3.2 at 3-month follow-up had more visits to physician, physiotherapist, occupational therapist and nurse, higher drug costs, more days in hospital and more extensive surgery compared with patients with 3-month DAS-28 < 3.2. Number of days lost from work due to sick leave and permanent work disability was also higher in this group. The effect of disease activity on health-related quality of life was highly significant. In regression models, DAS-28 at 3-month follow-up was significantly associated with costs over the following years. CONCLUSIONS: Three months after diagnosis, DAS-28 is an important prognostic marker regarding health-care utilization and costs. Achieving remission or low disease activity 3 months after diagnosis is likely to decrease morbidity, increase quality of life and save costs for the patient and for society over the following years.
Authors: N A Goyal; T M Cash; U Alam; S Enam; P Tierney; N Araujo; F H Mozaffar; A Pestronk; T Mozaffar Journal: J Neurol Neurosurg Psychiatry Date: 2015-04-09 Impact factor: 10.154
Authors: Shintaro Hirata; Linda Dirven; Yijing Shen; Michael Centola; Guy Cavet; Willem F Lems; Yoshiya Tanaka; Thomas W J Huizinga; Cornelia F Allaart Journal: Rheumatology (Oxford) Date: 2013-02-07 Impact factor: 7.580