Impact of impaired morning function on the lives and well-being of patients with rheumatoid arthritis.

Morning joint stiffness and pain are prominent features in patients suffering from rheumatoid arthritis (RA) and contribute to impaired function. A survey was conducted across 11 European countries to assess the impact of impaired morning function on patients' quality of life. A total of 518 rheumatologists, and 750 patients aged 18-75 years with RA for ≥ 6 months and impaired morning function at least three times a week, completed the structured questionnaires. Impaired morning function was defined as 'stiffness and pain in the joints first thing in the morning that results in difficulty to function or perform tasks'. The mean duration of morning stiffness and pain was 83 min according to patients, slightly longer than that estimated by rheumatologists (70 min). Impaired morning function lasting more than 30 min/day was reported by 75% of patients, with 76% of rheumatologists estimating this duration for their patients. Most respondents (82% of patients and 96% of rheumatologists) considered that impaired morning function had a significant effect on patient quality of life. Around two-thirds of patients reported changes in how they carry out usual morning activities. Patients who were unable to function normally in the morning reported feeling frustrated (58%) and angry (32%). Almost one in five patients in the survey (18%) was unable to work as a direct result of their RA. Of the 274 patients included in the survey who were in paid work, 73% reported that impaired morning function had a significant impact on their job; 40% missed time from work in the past 6 months due to impairment in morning function, resulting in a mean of 4.5 days lost from work/employed person. In conclusion, the survey shows that impaired morning function has a considerable impact on the lives and well-being of patients with RA.