Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis : Observational Data from Southern Sweden
(2016) In Journal of Rheumatology 43(7). p.1292-1299- Abstract
Objective. To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). Methods. Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare (patient care and drugs) and work loss costs (patients <65 yrs) were studied in separate regression models, comparing standardized â coefficients by... (More)
Objective. To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). Methods. Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare (patient care and drugs) and work loss costs (patients <65 yrs) were studied in separate regression models, comparing standardized â coefficients by nonparametric bootstrapping to assess which measure best reflects costs. Analyses were conducted based on both individual means (linear regression, comparing between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs. Results. Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work loss costs were also more closely associated with EQ-5D than DAS28. The results of the linear models for healthcare costs were standardized β = 0.21 (95% CI 0.15-0.27), 0.16 (0.11-0.21), and -0.15 (-0.21 to -0.10) for HAQ/DAS28/EQ-5D, respectively (p <0.05 for HAQ vs DAS28/EQ-5D). For work loss costs, the results were standardized β = 0.43 (95% CI 0.39-0.48), 0.27 (0.23-0.32), and -0.34 (-0.38 to 0.29) for HAQ/DAS28/EQ-5D, respectively (p <0.05 for HAQ vs DAS28/EQ-5D and for EQ-5D vs DAS28). Conclusion. Overall, HAQ disability is a better marker of RA costs than DAS28 or EQ-5D HRQOL.
(Less)
- author
- KARLSSON WALLMAN, JOHAN LU ; Eriksson, Jonas K. LU ; Nilsson, Jan Åke LU ; Olofsson, Tor LU ; Kristensen, Lars Erik LU ; Neovius, Martin and Geborek, Pierre LU
- organization
- publishing date
- 2016-07-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- COST OF ILLNESS, DISEASE ACTIVITY SCORE, OUTCOMES, RHEUMATOID ARTHRITIS, TUMOR NECROSIS FACTOR INHIBITORS
- in
- Journal of Rheumatology
- volume
- 43
- issue
- 7
- pages
- 8 pages
- publisher
- Journal of Rheumatology Publishing Company Limited
- external identifiers
-
- pmid:27252420
- wos:000380882000006
- scopus:84977276870
- ISSN
- 0315-162X
- DOI
- 10.3899/jrheum.150617
- language
- English
- LU publication?
- yes
- id
- 7e7bc5d2-aede-4c71-b48e-584c16c01359
- date added to LUP
- 2016-07-19 13:24:58
- date last changed
- 2024-08-09 16:19:24
@article{7e7bc5d2-aede-4c71-b48e-584c16c01359, abstract = {{<p>Objective. To compare how costs relate to disability, disease activity, and health-related quality of life (HRQOL) in rheumatoid arthritis (RA). Methods. Antitumor necrosis factor (anti-TNF)-treated patients with RA in southern Sweden (n = 2341) were monitored 2005-2010. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), and EQ-5D scores were linked to register-derived costs of antirheumatic drugs (excluding anti-TNF agents), patient care, and work loss from 30 days before to 30 days after each visit (n = 13,289). Associations of HAQ/DAS28/EQ-5D to healthcare (patient care and drugs) and work loss costs (patients <65 yrs) were studied in separate regression models, comparing standardized â coefficients by nonparametric bootstrapping to assess which measure best reflects costs. Analyses were conducted based on both individual means (linear regression, comparing between-patient associations) and by generalized estimating equations (GEE), using all observations to also account for within-patient associations of HAQ/DAS28/EQ-5D to costs. Results. Regardless of the methodology (linear or GEE regression), HAQ was most closely related to both cost types, while work loss costs were also more closely associated with EQ-5D than DAS28. The results of the linear models for healthcare costs were standardized β = 0.21 (95% CI 0.15-0.27), 0.16 (0.11-0.21), and -0.15 (-0.21 to -0.10) for HAQ/DAS28/EQ-5D, respectively (p <0.05 for HAQ vs DAS28/EQ-5D). For work loss costs, the results were standardized β = 0.43 (95% CI 0.39-0.48), 0.27 (0.23-0.32), and -0.34 (-0.38 to 0.29) for HAQ/DAS28/EQ-5D, respectively (p <0.05 for HAQ vs DAS28/EQ-5D and for EQ-5D vs DAS28). Conclusion. Overall, HAQ disability is a better marker of RA costs than DAS28 or EQ-5D HRQOL.</p>}}, author = {{KARLSSON WALLMAN, JOHAN and Eriksson, Jonas K. and Nilsson, Jan Åke and Olofsson, Tor and Kristensen, Lars Erik and Neovius, Martin and Geborek, Pierre}}, issn = {{0315-162X}}, keywords = {{COST OF ILLNESS; DISEASE ACTIVITY SCORE; OUTCOMES; RHEUMATOID ARTHRITIS; TUMOR NECROSIS FACTOR INHIBITORS}}, language = {{eng}}, month = {{07}}, number = {{7}}, pages = {{1292--1299}}, publisher = {{Journal of Rheumatology Publishing Company Limited}}, series = {{Journal of Rheumatology}}, title = {{Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis : Observational Data from Southern Sweden}}, url = {{http://dx.doi.org/10.3899/jrheum.150617}}, doi = {{10.3899/jrheum.150617}}, volume = {{43}}, year = {{2016}}, }