Kvalitet života i funkcijska sposobnost bolesnika sa reumatoidnim artritisom

Abstract

For the purpose of comprehensive review of patients suffering from RA, the physician's clinical assessment, laboratory and other diagnostic parameters are not enough. The patient's subjective experience of his/her illness, based on the results obtained through questionnaires and scales, provides data on damaged spheres or segments of quality of life, that are substantial to them, and thus taking adequate measures for the treatment, just those damaged segments. The objectives of this written paper are evaluation of functional capacity and quality of life in patients with RA, using the adequate questionnaires and scales, evaluation of the influence of the disease activity, socio-demographic, some laboratory parameters and biological therapy on the functional capacity and quality of life in these patients, as well as, comparison of quality of life in patients with RA to patients suffering from the OA knee. 152 patients were examined in the prospective clinical study: 101 with RA and 51 with OA knee. All subjects, beside clinical examination and additional diagnostic methods, had their quality of life evaluated by the questionnaires and scales SF36, EQ5D, QOL RA, VASP, VASGH, VASF, FFS, FSS and BDI, and patients with RA had their functional capacity evaluated by the HAQ questionnaire, as well as, according to functional classes by Steinbrocker. As soon as the study has been completed, it has been concluded that the high activity of the disease causes the higher level of HAQ functional disability, greater intensity of pain, fatigue, depression, worse general health, significantly impairs both physical and mental sphere of the quality of life, as well as, the total quality of life. More difficult degree of HAQ functional disability and more difficult functional class by Steinbrocker reflect higher intensity of pain, fatigue, depression, worse general health, significantly impairs both physical and mental sphere of the quality of life, and total quality of life, as well. Age, CRP and RF presence did not significantly affect the functional disability or poor quality of life. Patients, who do not receive biological therapy, as well as, those with longer duration of the disease, associated comorbidities and ACPA presence, have presented more difficult degree of the functional disability and worse quality of life, as well. Patients with RA in regard to patients with knee OA showed significantly worse all evaluated parameters of quality of life: fatigue, depression, general health, mental and physical sphere of the quality of life, total quality of life; only the intensity of pain did not significantly differ. Used questionnaires and scales for the evaluation of the functional ability and quality of life in patients with RA, complement the overall clinical picture of these patients and significantly contribute to the monitoring of the achieved results of the treatment. Prompt evaluation of the quality of life and functional abilities using questionnaires and scales, make it possible to identify impaired segments and spheres, with prompt taking measures to preserve them.