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Tytuł:
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Patient global assessment is elevated by up to 5 of 10 units in patients with inflammatory arthritis who screen positive for fibromyalgia (by FAST4) and/or depression (by MDS2) on a single MDHAQ.
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Autorzy:
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Schmukler J; Division of Rheumatology, Department of Medicine, Rush University School of Medicine, Chicago, IL 60612, United States.
Li T; Department of Biostatistics, Bioinformatics & Biomathematics, Georgetown University, Washington, DC 20057, United States.
Gibson KA; Department of Rheumatology, Liverpool Hospital, Ingham Research Institute, University of New South Wales, Sydney, NSW 2170, Australia.
Morla RM; Department of Rheumatology, Hospital Clinic Universitari de Barcelona, Institut d´investigacions Biomèdiques August Pi i Sunyer, 08036 Barcelona, Spain.
Luta G; Department of Biostatistics, Bioinformatics & Biomathematics, Georgetown University, Washington, DC 20057, United States.
Pincus T; Division of Rheumatology, Department of Medicine, Rush University School of Medicine, Chicago, IL 60612, United States. Electronic address: .
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Źródło:
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Seminars in arthritis and rheumatism [Semin Arthritis Rheum] 2023 Feb; Vol. 58, pp. 152151. Date of Electronic Publication: 2022 Dec 09.
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Typ publikacji:
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Journal Article; Research Support, Non-U.S. Gov't
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Język:
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English
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Imprint Name(s):
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Publication: Philadelphia Pa : W.B. Saunders
Original Publication: New York, Stratton.
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MeSH Terms:
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Fibromyalgia*/diagnosis
Arthritis, Rheumatoid*/complications
Arthritis, Rheumatoid*/diagnosis
Humans ; Depression/diagnosis ; Surveys and Questionnaires ; Inflammation ; Severity of Illness Index
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Contributed Indexing:
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Keywords: MDHAQ; Multidimensional health assessment questionnaire, FAST4, Fibromyalgia assessment screening tool, MDS2, Depression, RA, SpA, AxSpA, PsA; PATGL; Patient global assessment
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Entry Date(s):
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Date Created: 20221231 Date Completed: 20230117 Latest Revision: 20230130
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Update Code:
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20240105
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DOI:
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10.1016/j.semarthrit.2022.152151
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PMID:
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36586208
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Background: Patient global assessment (PATGL) is a component of rheumatoid arthritis (RA) and spondyloarthritis (SpA) activity indices, reflecting inflammation in selected clinical trial patients. In routine care, PATGL often may be elevated independently of inflammatory activity by fibromyalgia (FM) and/or depression, leading to complexities in interpretation. A feasible method to screen for FM and/or depression could help to clarify interpretation of high PATGL and index scores, including explanation of apparent limited responses to anti-inflammatory therapies.
Patients and Methods: Patients with RA or SpA in routine care in Barcelona, Chicago, and Sydney complete a 2-page multidimensional health assessment questionnaire (MDHAQ) in 5-10 min. The MDHAQ includes PATGL and three indices, RAPID3 (routine assessment of patient index data) to assess clinical status, FAST4 (0-4 fibromyalgia assessment screening tool) and MDS2 (0-2 MDHAQ depression screen). PATGL was compared for each diagnosis at each site and pooled data in FAST4 positive (+) vs negative (-) and/or MDS2+ vs MDS2- patients using medians and median regressions.
Results: Median PATGL was 5.0 in 393 RA and 175 SpA patients; 2.0-3.0 in 305 (58.9%) FAST4-,MDS2- patients, 5.5-6.0 in 71 (13.7%) FAST4-,MDS2+ patients, 7.0-7.5 in 50 (9.7%) FAST4+,MDS2- patients, and 7.0-8.0 in 92 (17.8%) FAST4+,MDS2+ patients. Positive FAST4 and/or MDS2 screens were seen in 41% of patients. Results were similar in RA and SpA at 3 settings on 3 continents.
Conclusion: Median 0-10 PATGL varied from 2-3/10 to 5.5-8/10, according to negative vs positive screening for FM and/or depression on a single MDHAQ for busy clinical settings.
(Copyright © 2022. Published by Elsevier Inc.)
