Title:Influencing Factors in Tunisian Rheumatoid Arthritis Patients’ Quality of
Life: Burden and Solutions
Volume: 19
Issue: 3
Author(s): Soumaya Boussaid*, Sarra Jeriri, Sonia Rekik, Emna Hannech, Samia Jammali, Elhem Cheour, Hela Sahli and Mohamed Elleuch
Affiliation:
- Rheumatology Department, Rabta Hospital, Tunis, Tunisia
Keywords:
Rheumatoid arthritis, quality of life, depression, anxiety, fatigue, mental health.
Abstract:
Background: Rheumatoid Arthritis (RA) is a disease with a heavy functional, psychological,
and socioeconomic impact. The management of Quality of Life (QoL) as a therapeutic objective
is a fairly recent notion, especially in Tunisia. We aimed to evaluate QoL in RA patients and to
identify its affecting factors.
Methods: This was a cross-sectional study in a Tunisian rheumatology center. To assess QoL, we
used the Short Form Health Survey (SF-36) and the Arthritis Impact Measurement Scales Short
Form (AIMS2-SF). Health Assessment Questionnaire Disability Index (HAQ), the Hospital Anxiety
and Depression Scale (HAD) for psychological disorders, Visual Analog Scale for Pain (VAS Pain),
and for fatigue (VAS Fatigue) were also used. Disease activity was assessed by the Disease Activity
Score (DAS28 CRP).
Results: We enrolled 120 established RA, the mean age of our patients was 56.9 ± 11.4 years, with
a predominance of women (83.3%). The mean disease duration was 10.97 ± 7.7 years. According to
the HAD scale, 27% of our patients presented anxiety, and 26.7% had depressive disorders. There
was significantly impaired QoL in patients with low educational level, dependent financial situation,
long disease duration, high disease activity, high pain and fatigue levels, poor therapeutic education,
functional disability, and psychological disorders (p < 0.001). A strong negative correlation
was detected between inflammatory markers, structural damage, and the scores of QoL. Patients
under biologics scored significantly higher in the SF36 mental health domain (p < 0.001).
Conclusion: QoL is significantly poor in Tunisian RA. These patients should be managed using a
multidisciplinary approach involving the patients themselves.
