Session Information
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Rheumatoid Arthritis (RA) is known to be associated with an increased risk of comorbidity, premature mortality, and disability. We investigated the effect of comorbidity on health-related quality of life (HRQOL) and total healthcare expenditure (TE) in patients with RA.
Methods: Adult RA patients were identified from the Medical Expenditure Panel Survey 2010 to 2012 data. Twenty-six comorbid conditions were identified including cardiovascular, endocrine, respiratory, psychological, cancer, skin, vision, and gastrointestinal disorders. The Short Form (SF)-12 physical component summary (PCS) and mental component summary (MCS) scores for HRQOL, and TE (2012 USD) were summarized based on the number of comorbidity as well as type of comorbidity using descriptive statistics. Outcomes were further investigated using multivariable regression analyses. Adjusted mean PCS/MSC scores and TE were reported along with bootstrapped confidence intervals. All analyses considered sampling strata and weights in survey design.
Results: A total of 1,982 patients with RA were identified representing 18 million US population. The mean (SE) age was 61.2 (0.53) years and mean (SE) duration of RA was 17.2 (0.57) years. Approximately 30.5% had 1 to 2, 34.5% had 3 to 4 and 23.6% had ≥5 comorbid conditions. The most prevalent comorbidities were cardiovascular (73.4%) and endocrine disorders (35.6%). The mean (SE) PCS/MCS scores for RA with comorbidity were lower compared to RA without comorbidity [PCS: 32.3 (0.58) vs. 37.5 (1.93), p=0.012; MCS: 42.8 (0.59) vs. 47.3 (1.66), p= 0.013]; whereas the mean (SE) TE for RA with comorbidity was higher compared to RA without comorbidity [TE: $ 13,951 ($729) vs. $7,947 ($1,393), p<0.001]. Having multiple comorbidities was associated with a significant impact on both HRQOL and TE (Table). Adjusting for confounders, having ³ 5 comorbid conditions was associated with a decrease in PCS/MCS [PCS: -6.75 for ³ 5 comorbidities vs. none; MCS: -7.15 for ³ 5 comorbidities vs. none, respectively] and an increase in TE compared to no comorbidity [$4,637 for 3-4 comorbidities vs. none, $13,842 for ³ 5 comorbidities vs. none, respectively]. Only selected types of comorbidity were associated with changes in MCS/PCS or TE.
Conclusion: Majority of RA patients have at least one comorbidity and substantial number of patients had multiple comorbid conditions. Presence of comorbidity in RA was associated with significant impact in both HRQOL and TE. The impact was higher as the number of comorbidity increases regardless of the type of comorbidity. Table. Adjusted Means (95% Bootstrapped CI) of Health-Related Quality of Life and Total Healthcare Expenditure by Number of Comorbid Conditions
|
Number of Comorbid Conditions |
Physical Component Score |
Mental Component Score |
Healthcare Expenditure (2012 USD) |
| None |
35.2 (32.0 – 38.1) |
46.8 (43.2 – 49.7) |
$8,189 ($6,018 – $10,744) |
| 1-2 |
35.1 (33.5 – 36.5) |
42.9 (41.1 – 44.5) |
$8,376 ($6,848 – $9,797) |
| 3-4 |
31.6 (30.3 – 32.9) |
42.8 (41.3 – 44.2) |
$12,767 ($11,333 – $14,408) |
| 5 or more |
28.4 (27.1 – 29.9) |
39.6 (38.0 – 41.5) |
$21,329 ($18,527 – $24,845) |
*adjusted for age, sex, race/ethnicity, marital status, education, insurance, and poverty
To cite this abstract in AMA style:
Nyarko E, An J. Impact of Comorbidity on Health-Related Quality of Life and Healthcare Expenditure in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/impact-of-comorbidity-on-health-related-quality-of-life-and-healthcare-expenditure-in-patients-with-rheumatoid-arthritis/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-comorbidity-on-health-related-quality-of-life-and-healthcare-expenditure-in-patients-with-rheumatoid-arthritis/