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A Comparative Study of Patient-Reported Functional Outcomes in Acute Rheumatoid Arthritis
JANE ZOCHLING, GEROLD STUCKI, EVA GRILL, and JÜRGEN BRAUN ABSTRACT. Objective. To assess the performance of the Barthel Index (BI) in patients with rheumatoid arthritis (RA) in the acute care hospital, as compared to the Stanford Health Assessment Questionnaire (HAQ) and the Hannover Functional Questionnaire (Funktionsfragebogen Hannover, FFbH). Methods. A prospective study of 97 patients with RA admitted to an acute rheumatology hospital with new onset or acute flare of RA. Patients were required to self-complete the BI, the HAQ, and the FFbH. Disease activity was measured using the Disease Activity Score (DAS28). Results. Seventy-eight percent of patients were female, average age was 61.5 (SD 12.5) years, and 72.2% were rheumatoid factor-positive. The median HAQ was 1.29 (range 0–3), median FFbH was 50% (6–100%), and median BI was 95 (0–100), and distribution was highly skewed. All measures of physical functioning were significantly correlated with each other and with the DAS28; however, the BI discriminated poorly between low and high disease activity. Conclusion. The BI is not a useful instrument to assess physical functioning in patients with acute symptoms of RA, but may have a role in assessing patients with comorbidities and in assessing nursing care needs in the acute care hospital. (First Release Nov 15 2006; J Rheumatol; 2007:34:64–9) Key Indexing terms:
RHEUMATOID ARTHRITIS From the Rheumazentrum-Ruhrgebiet, Herne; and the ICF Research Branch of the WHO FIC Collaborating Center (DIMDI), IHRS, and Department of Physical Medicine and Rehabilitation, Ludwig Maximilians University, Munich, Germany. J. Zochling, MBBS, PhD, Postdoctoral Research Fellow, Rheumazentrum-Ruhrgebiet; G. Stucki, MD, Professor of Rheumatology and Rehabilitation Medicine, Department of Physical Medicine and Rehabilitation, Ludwig Maximilians University; E. Grill, MPH, Epidemiologist, ICF Research Branch, WHO FIC Collaborating Center (DIMDI), IMBK, Ludwig Maximilians University; J. Braun, MD, Professor of Rheumatology, Rheumazentrum-Ruhrgebiet. Address reprint requests to Prof. J. Braun, Rheumazentrum-Ruhrgebiet, Landgrafenstrasse 15, 44652 Herne, Germany. Accepted for publication August 28, 2006. |
