Three instruments were used for a comparative analysis of the QOL in patients with early and established RA: special, general and disease-specific questionnaires.
According to the results obtained using the HAQ, 43% of respondents with early RA and 56% of respondents with established RA had severe functional disorders. It indicated that regardless of the duration of the disease, the active pathological process in most of them led to a significant decrease in functional abilities. Thus, a significant part of patients (77.2%) already in the early stages of RA needed outside help and the use of devices. With the increase in the duration of RA, restrictions in "hygiene", "arising", "walking" in patients were intensified.
The survey by the SF-36 revealed impairment of physical, psychological and social functioning starting from the early stages of RA. Regardless of the duration of RA, difficulties in work or other activities occurred mainly due to physical status, although in interviewed participants with early RA, the PCS indicators suffered less than in patients with long-term disease. At the same time, RA patients on early stages were more likely to experience limitations due to physical pain. In 62.3% of cases initially they assessed the health as "much worse than a year ago".
The use of the QOL-RA Scale in this clinical study found that patients with early RA gave the worst scores for the "arthritis" and "joint pain", and participants with established RA for "health" also, but at any duration of the disease RA patients were satisfied with the support from family and friends. This specific questionnaire that assesses the impact of arthritis on QOL excludes the effects of the comorbidities if there are doubts when using a general questionnaire (SF-36 in our case). At the same time the use of three questionnaires meets the requirements for QOL studies.
Previous studies did not aim to compare the QOL of the RA patients with different disease duration using HAQ, SF-36, QOL-RA Scale. The application of these questionnaires for scientific purposes allows already in the early stages of the RA to identify the indicators that are most susceptible to deterioration of the quality of life, which means that they can be used as additional criteria for the effectiveness of treatment, primarily when testing new drugs or choosing a therapy strategy by drugs with proven effectiveness. This part of the scientific study has limitations in this publication due to the fact that it does not include comparative results of the effectiveness of drugs for the treatment of early RA, which are described in other articles.