Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose:
Arthritis is the leading cause of disability in the US and impacts on multiple aspects of health-related quality of life (HRQoL). Many multidimensional HRQoL measures used in arthritis have complex scoring algorithms and are sometimes proprietary limiting their utility in clinical care and research. The Patient Reported Outcome Measurement Information System (PROMIS) was developed by NIH using modern psychometrics to provide publicly available, population normalized measures to assess domains of physical, emotional, and social health. Assessments of PROMIS measures in arthritis have been limited to pain, function and fatigue in small numbers of patients. It was our goal to evaluate PROMIS measures in a large group of adults with self-reported arthritis.
Methods:
Six PROMIS short forms for pain interference (6 items), physical function (10), fatigue (7), sleep quality (8), depression (8), and satisfaction with social roles (7) were administered to community dwelling adults with self-reported arthritis enrolled in the Walk with Ease (WWE) study. Raw scores were transformed to T scores for analysis, with the population mean 50 and standard deviation 10. Other measures included general health; pain, fatigue and stiffness VAS; and the improved HAQ (score range 0 to 100). Analyses were conducted to examine the effect of age and BMI using Stata 12.
Results:
Instruments were administered to 439 adults with arthritis: 88% female, 70% White, 26% Black or African-American; general health 34% very good and excellent, 48 % good and 18 % fair; mean (SD) age 64 (12) BMI 30 (7); pain VAS 38.1 (25.3) fatigue VAS 37.3 (28.3), stiffness VAS 42.4 (26.7), IHAQ 14 (14). Mean (SD) PROMIS T scores were: pain interference 54.5 (6.9), fatigue 52.3 (8.3), physical function 42.8 (6.5), depression 49 (7.8), sleep quality 50.1 (9.66), satisfaction with social roles 48.6 (9). After adjustment for age, T scores were significantly worse for obese vs. non-obese for pain interference, fatigue, physical function, satisfaction social roles (Table).
Conclusion:
PROMIS measures identify worse pain interference, fatigue, and physical function in people with self-reported arthritis compared to population-based norms. PROMIS social role satisfaction measures indicate arthritis impacts participation in valued life activities. Significantly worse fatigue (0.4 SD) and decreased satisfaction with social roles (0.4 SD) were seen in obese vs. non-obese, after adjustment for age. Studies are ongoing to evaluate responsiveness of PROMIS measures compared with legacy measures with an exercise intervention in the WWE study. Further studies are needed to evaluate the impact of obesity on other measures of HRQL in individuals with arthritis.
Table. PROMIS T scores in obese versus non-obese people with self-reported arthritis
|
|
T scores Mean (SD) |
|
|
|
|
BMI<30 (n=254) |
BMI ≥30 (n=185) |
Age adjusted p-value
|
|
PROMIS Pain Interference
|
53.4 (7.4) |
55.9 (6.3) |
<0.001 |
|
PROMIS Fatigue
|
50.7 (8.3) |
54.5 (7.8) |
<0.001 |
|
PROMIS Physical Function*
|
43.8 (6.7) |
41.4 (5.9) |
<0.001 |
|
PROMIS Depression
|
48.4 (7.3) |
49.8 (8.4) |
0.1 |
|
PROMIS Sleep Quality
|
49.9 (9.7) |
50.6 (9.4) |
0.7 |
|
PROMIS Satisfaction with Social Roles |
50.1 (8.8) |
46.4 (9.0) |
<0.001 |
*Lower scores represent worse physical function
Disclosure:
A. M. Orbai,
None;
L. F. Callahan,
None;
R. J. Cleveland,
None;
S. R. Ghazarian,
None;
S. J. Bartlett,
None;
C. O. Bingham III,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/examining-patient-reported-outcome-measurement-information-system-measures-in-community-dwelling-adults-with-arthritis/