The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: A systematic review and meta-analysis☆☆

https://doi.org/10.1016/j.semarthrit.2014.05.001Get rights and content
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Abstract

Objective

The assessment of health-related quality-of-life (HRQoL) in rheumatoid arthritis (RA) is becoming increasingly common in both research and clinical practice. One of the most widely used tools for measuring HRQoL is the Medical Outcomes Study 36-item Short-Form Health Survey (SF-36). We conducted a systematic review examining the impact of RA on HRQoL, measured through the SF-36.

Methods

MEDLINE and Embase were searched for observational studies reporting mean and standard deviation scores for each domain of the SF-36 in adult RA patients. Studies were reviewed in accordance with PRISMA guidelines, and a random-effects meta-analysis was performed.

Results

In total, 31 studies were eligible for inclusion in the meta-analysis, including 22,335 patients. Meta-analyses found that pooled mean HRQoL score for the SF-36 physical component summary was 34.1 (95% CI: 22.0–46.1) and mental component summary was 45.6 (95% CI: 30.3–60.8). Increased age was associated with reduced physical function and physical component summary (PCS) scores but improved mental health and mental component summary (MCS) scores. Female gender was associated with improved scores on role physical, bodily pain and PCS but reduced mental health and MCS scores. Longer disease duration was associated with improved MCS. Patients with RA have a substantially reduced HRQoL in comparison to both other physical illnesses and in comparison to normative datasets from UK and USA populations.

Conclusions

RA has a substantial impact on HRQoL. This supports recent NICE guidelines stipulating that RA patients should be regularly assessed for the impact their disease has on HRQoL and appropriate management provided.

Keywords

Systematic review
Meta-analysis
Rheumatoid arthritis
Health-related quality-of-life
Medical Outcomes Study 36-item Short-Form Health Survey
SF-36

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Funding: F.M., L.R. and M.H. receive salary support from the National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King׳s College London. I.C.S. receives funding from Arthritis Research UK (Grant reference number 19739). G.H.K. and S.S. receive NHS funding. D.L.S. receives funding from the National Institute for Health Research, UK, Programme Grant on “Treatment intensities and targets in rheumatoid arthritis therapy: integrating patients׳ and clinicians׳ views—the TITRATE programme” (RP-PG-0610-10066).

☆☆

The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.