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Handicap in inflammatory arthritis

R H Harwood1, A J Carr, P W Thompson

  • 1Department of Public Health, Royal Free Hospital Medical School, London.

British Journal of Rheumatology
|September 1, 1996
PubMed
Summary
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This study found that measuring both impairments and disabilities is crucial for understanding the full impact of rheumatic diseases. Relying solely on clinical measures may provide a misleading picture of patient outcomes.

Area of Science:

  • Rheumatology
  • Clinical Assessment
  • Patient Outcomes

Background:

  • Rheumatic diseases impose a significant burden on patients, affecting daily life.
  • Accurate assessment of disease impact is essential for effective management and treatment.
  • Existing measures may not fully capture the multifaceted nature of disease burden.

Purpose of the Study:

  • To evaluate and compare two handicap measurement instruments.
  • To assess their correlation with clinical, laboratory, disability, and impairment measures in rheumatology patients.
  • To determine the comprehensive impact of rheumatic disease on patients' lives.

Main Methods:

  • 133 rheumatology patients were assessed at baseline and 102 were followed up after 3 months.
  • Measurements included acute-phase response, stiffness, pain, wellbeing, joint involvement (impairments), Stanford Health Assessment Questionnaire (disability), Disease Repercussion Profile, and London Handicap Scale (handicap).

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  • Correlations between different measures were analyzed using rho.

    • Main Results:

    • A substantial burden of disability and handicap was observed in the patient cohort.
    • Moderate correlations were found between impairments and other measures (0.4 < rho < 0.6).
    • Moderate to strong correlations existed between disability and handicap measures (0.4 < rho < 0.8), while impairment and disability/handicap correlations were weak (rho < 0.4).

    Conclusions:

    • A comprehensive understanding of disease and treatment impact necessitates measuring impairments, disabilities, and handicaps.
    • Clinical and laboratory variables alone may not adequately represent the patient's overall condition.
    • Integrated assessment approaches are vital for accurate rheumatology patient evaluation.