28-joint count disease activity score at 3 months after diagnosis of early rheumatoid arthritis is strongly associated with direct and indirect costs over the following 4 years: the Swedish TIRA project
2011 (English)In: Rheumatology, ISSN 1462-0324, 1462-0332, Vol. 50, no 7, 1259-1267 p.Article in journal (Refereed) Published
Methods. Three-hundred and twenty patients with early (1 year) RA were assessed at regular intervals. Clinical and laboratory data were collected and patients reported health-care utilization and number of days lost from work. At 3-month follow-up, patients were divided into two groups according to disease activity, using DAS-28 with a cut-off level at 3.2. Direct and indirect costs and EuroQol-5D over the following 4 years were compared between the groups. Multivariate regression models were used to control for possible covariates. Results. Three months after diagnosis, a DAS-28 level of epsilon 3.2 was associated with high direct and indirect costs over the following 4 years. Patients with DAS-28 epsilon 3.2 at 3-month follow-up had more visits to physician, physiotherapist, occupational therapist and nurse, higher drug costs, more days in hospital and more extensive surgery compared with patients with 3-month DAS-28 less than 3.2. Number of days lost from work due to sick leave and permanent work disability was also higher in this group. The effect of disease activity on health-related quality of life was highly significant. In regression models, DAS-28 at 3-month follow-up was significantly associated with costs over the following years. Conclusions. Three months after diagnosis, DAS-28 is an important prognostic marker regarding health-care utilization and costs. Achieving remission or low disease activity 3 months after diagnosis is likely to decrease morbidity, increase quality of life and save costs for the patient and for society over the following years.
Place, publisher, year, edition, pages
Oxford University Press , 2011. Vol. 50, no 7, 1259-1267 p.
Early rheumatoid arthritis; Disease activity score-28; Prognosis; Direct costs; Indirect costs; EuroQol-5D
National CategoryMedical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-69837DOI: 10.1093/rheumatology/keq444ISI: 000291746100014OAI: oai:DiVA.org:liu-69837DiVA: diva2:433464
Original Publication: Eva Hallert, Magnus Husberg and Thomas Skogh, 28-joint count disease activity score at 3 months after diagnosis of early rheumatoid arthritis is strongly associated with direct and indirect costs over the following 4 years: the Swedish TIRA project, 2011, Rhematology Int, (50), 7, 1259-1267. http://dx.doi.org/10.1093/rheumatology/keq444 Copyright: Oxford University Press http://www.oxfordjournals.org/2011-08-102011-08-082015-08-31