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Costs in Relation to Disability, Disease Activity, and Health-related Quality of Life in Rheumatoid Arthritis : Observational Data from Southern Sweden

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 (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.

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organization
publishing date
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
  • scopus:84977276870
  • pmid:27252420
  • wos:000380882000006
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
2024-04-19 06:20:50
@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 &lt;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 &lt;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 &lt;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}},
}