T Uutela1,2, H Kautiainen3,4,5, S Järvenpää5, M Hakala6, A Häkkinen7,8. 1. a Department of Medicine , Central Hospital of Lapland , Rovaniemi , Finland. 2. b Medical Research Centre Oulu , Oulu University Hospital and University of Oulu , Finland. 3. c Unit of Primary Health Care and Department of General Practice , Helsinki University Hospital, Helsinki , Finland. 4. d Unit of Primary Health Care , Kuopio University Hospital , Kuopio , Finland. 5. e Research Department , Medcare Foundation , Äänekoski , Finland. 6. f Department of Medicine , Päijät-Häme Central Hospital , Lahti , Finland. 7. g Department of Physical and Rehabilitation Medicine , Central Hospital of Jyväskylä , Finland. 8. h Department of Health Science , University of Jyväskylä , Finland.
Abstract
OBJECTIVES: Self-rated health (SRH) is a well-known overall health status measure used in the general population but it is rarely examined in a clinical setting. We assessed SRH-related factors in clinic-based patients with rheumatoid arthritis (RA). METHOD: The study included 123 consecutive outpatients treated in 1998-1999. Patient questionnaires, including a single SRH item, sociodemographics, the Health Assessment Questionnaire (HAQ) for functional ability, and the Nottingham Health Profile (NHP) for health-related quality of life (QoL), were collected at baseline. Comorbidities were measured by the Charlson Comorbidity Index (CCI) and data on the use of drugs and surgery for RA were verified from medical records and by querying patients. Factors associated with SRH were examined using regression models with the propensity score as the covariate. Mortality rates were collected up to 31 December 2014. Hazard ratios (HRs) were used to estimate SRH-associated mortality. RESULTS: In univariate analysis, poor SRH was associated with higher age and poorer patient-reported outcomes (PROs) but not with gender and clinical variables. After adjustment for the propensity score, the NHP dimensions for pain, energy, emotional reactions, and mobility remained significantly associated with SRH. The age- and sex-adjusted HR for death was 2.38 [95% confidence interval (CI) 1.13-5.04, p = 0.034] for the patients with poor vs. good SRH. The propensity score-adjusted HR for death was 1.69 (95% CI 0.74-3.86, p = 0.21). Conclusions In patients with RA, SRH was associated with health-related QoL dimensions, reflecting patients' well-being rather than clinical factors. During the 16 years of follow-up, SRH had no independent association with mortality.
OBJECTIVES: Self-rated health (SRH) is a well-known overall health status measure used in the general population but it is rarely examined in a clinical setting. We assessed SRH-related factors in clinic-based patients with rheumatoid arthritis (RA). METHOD: The study included 123 consecutive outpatients treated in 1998-1999. Patient questionnaires, including a single SRH item, sociodemographics, the Health Assessment Questionnaire (HAQ) for functional ability, and the Nottingham Health Profile (NHP) for health-related quality of life (QoL), were collected at baseline. Comorbidities were measured by the Charlson Comorbidity Index (CCI) and data on the use of drugs and surgery for RA were verified from medical records and by querying patients. Factors associated with SRH were examined using regression models with the propensity score as the covariate. Mortality rates were collected up to 31 December 2014. Hazard ratios (HRs) were used to estimate SRH-associated mortality. RESULTS: In univariate analysis, poor SRH was associated with higher age and poorer patient-reported outcomes (PROs) but not with gender and clinical variables. After adjustment for the propensity score, the NHP dimensions for pain, energy, emotional reactions, and mobility remained significantly associated with SRH. The age- and sex-adjusted HR for death was 2.38 [95% confidence interval (CI) 1.13-5.04, p = 0.034] for the patients with poor vs. good SRH. The propensity score-adjusted HR for death was 1.69 (95% CI 0.74-3.86, p = 0.21). Conclusions In patients with RA, SRH was associated with health-related QoL dimensions, reflecting patients' well-being rather than clinical factors. During the 16 years of follow-up, SRH had no independent association with mortality.
Authors: William Ian Andrew Bonner; Robert Weiler; Rotimi Orisatoki; Xinya Lu; Mustafa Andkhoie; Dana Ramsay; Mohsen Yaghoubi; Megan Steeves; Michael Szafron; Marwa Farag Journal: Int J Equity Health Date: 2017-06-06