Quality of life and work in patients with rheumatoid arthritis and ankylosing spondylitis of working age

• Published in: Annals of the rheumatic diseases Vol. 62; no. 12; pp. 1178 - 1184
• Main Authors: Chorus, A M J, Miedema, H S, Boonen, A, van der Linden, Sj
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.12.2003; BMJ; BMJ Publishing Group LTD
• Subjects: Adaptation, Psychological; Adolescent; Adult; Age; analysis of covariance; ANCOVA; ankylosing spondylitis; Arthritis, Rheumatoid - psychology; BASDAI; Bath Ankylosing Spondylitis Disease Activity Index; Biological and medical sciences; Comorbidity; Coping with Rheumatic Stressors; CORS; Demographics; Diseases of the osteoarticular system; Employment; Extended Report; Fatigue - etiology; Female; Health Status; Humans; Inflammatory joint diseases; Male; MCS; Medical sciences; mental component summary; Mental Health; MFI; Middle Aged; Multidimensional Fatigue Inventory; Pain; Patients; PCS; physical component summary; QOL; Quality of Life; RADAI; Rheumatic diseases; Rheumatoid arthritis; Rheumatoid Arthritis Disease Activity Index; SDR; SF-36; Short Form-36; Spondylitis, Ankylosing - psychology; Standardised Diagnosis Register of Rheumatic Diseases; Surveys and Questionnaires; work; Netherlands; Spondylarthropathy; Human; Immunopathology; Chronic; Rheumatoid arthritis; Diseases of the osteoarticular system; Work; Autoimmune disease; Inflammatory joint disease; Comparative study; Ankylosing spondylitis; Quality of life
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2002.004861

Objective: To investigate the relationship between work and quality of life (QOL) in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) aged 16–59. Methods: 1056 patients with RA and 658 with AS were included in the study. Data were obtained by postal questionnaire, which included several generic and disease related QOL instruments. Separate dimensions and physical and mental summary scores from the SF-36 were compared. Stepwise multiple regression was performed to study the relationship between work and physical and mental health related QOL, including disease related factors, coping, and fatigue. Results: Physical health related QOL was reported to be worse, and mental health related QOL better, in RA than in AS in people of working age. No differences between RA and AS were found in somatic pain, physical role functioning, social functioning, emotional role functioning, vitality, or general health perception; nor were there any significant differences in fatigue and behavioural coping styles. Work was positively associated with physical health related QOL in both groups and, after disease characteristics, was the most important determinant. No association was found with mental health related QOL. Conclusions: Although physical health related QOL was worse in patients with RA, the impact on several dimensions of health related QOL in patients with RA and AS of working age under rheumatological care was comparable. Patients with RA and AS experienced similar limitations in physical role functioning, including work. Work is an important independent external determinant of physical health related QOL, but not of mental health related QOL.