Date: Monday, November 6, 2017
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Patient reported outcomes are recognized as increasingly important in defining the full burden of disease experienced by patients with rheumatic disease. Traditional measures of remission (DAS28, CDAI, SDAI, Rapid 3) are important in the treat-to-target paradigm as measures of response to treatment, but it is increasingly recognized that these measures cannot capture the full yoke that subjects with rheumatic disease endure. Furthermore, as modern rheumatology advances, it is increasingly difficult to capture the complete spectrum of the patient response to therapies using traditional measures. This primary objective of this study was to examine the relationship between DAS28CRP and fatigue, health, and mood using a novel electronic PRO delivery system.
We utilized the Optimising Patient Outcome in Australian rheumatoLogy (OPAL) database employing a unique electronic questionnaire delivery system to obtain PRO information from rheumatology patients on a quarterly basis and/or prior to patient-physician consultation. The software enables an email to be delivered to the patient automatically, and the patient is invited to complete a validated PRO questionnaire by smartphone, tablet or desktop. Completed questionnaires are securely fed back into the patient’s electronic health record (EHR) for discussion at the next consultation. PRO’s collected included fatigue (FACIT-F), mood (PHQ-2), overall health (SF-1) and RAPID3 components. PROs were correlated with DAS28CRP using Pearson product-moment correlation coefficient.
12,575 PROs have been returned from 1625 unique patients with a completion rate of approximately 70%. There was a weak correlation between fatigue and DAS28CRP (R2=-0.40); CDAI (R2 =-0.41) HAQ-DI (-0.60). However, a significant proportion of patients in low disease activity (LDA) and remission reported ongoing fatigue. Patient perception of their overall health was similar with 22% of patients in remission and 33% of patients in LDA reporting fair or poor health. Furthermore, 41% of patients in LDA and 31% of patients in remission reported feeling down in the previous 2 weeks.
Fatigue, mood disturbance, and poor health are reported by a considerable proportion of subjects in DAS28CRP LDA and remission. These results underline the importance of PROs in documenting the full impact of rheumatic disease and the patient response to therapy.
To cite this abstract in AMA style:Bird P, Griffiths H, Littlejohn G, Youssef P, Joshua F, Nash P, De Jager J, Smith T, Sanburg J, Tymms K. Fatigue, Poor Health and Mood Disturbance Persist in Rheumatoid Arthritis and Psoriatic Arthritis Patients Despite Disease Remission: The OPAL Deeper Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/fatigue-poor-health-and-mood-disturbance-persist-in-rheumatoid-arthritis-and-psoriatic-arthritis-patients-despite-disease-remission-the-opal-deeper-study/. Accessed February 28, 2020.
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