Health related quality of life in rheumatoid arthritis, osteoarthritis, diabetes mellitus, end stage renal disease and geriatric subjects. Experience from a General Hospital in Mexico.

INTRODUCTION Chronic diseases have a great impact in the morbidity and mortality and in the health-related quality of life (HRQoL) of patients around the world. The impact of rheumatic diseases has not been fully recognized. We conducted a comparative study to evaluate the HRQoL in different chronic diseases. OBJECTIVES The aim of the present study was to assess the HRQoL and identify specific areas affected in patients with rheumatoid arthritis (RA), osteoarthritis (OA), diabetes mellitus, end-stage renal disease, geriatric subjects and a control group. PATIENTS AND METHODS We conducted a cross-sectional study, in a General Hospital in Morelia, Mexico. All patients met classification criteria for RA, OA, diabetes mellitus, end-stage renal disease; the geriatric subjects group was≥65 years, and the control group≥30 years. Demographic characteristics were recorded, different instruments were applied: SF-36, visual analogue scale for pain, patient's and physician's global assessments, Beck Depression Inventory and specific instruments (DAS-28, HAQ-Di, WOMAC, Diabetes Quality of Life [DQOL] and Kidney Disease Questionnaire of Life [KDQOL]). Biochemical measures: erythrocyte sedimentation rate, blood count, glucose, HbA1C, serum creatinine and urea. RESULTS We evaluated 290 subjects (control group: 100; geriatric subjects: 30 and 160 for the rest of groups). Differences were detected in baseline characteristics (P<.0001). The SF-36 scores were different between control group and others groups (P=0.007). The worst HRQoL was in end-stage renal disease group (±SD: 48.06±18.84 x/SD). The general health was the principal affected area in RA. The pain was higher in rheumatic diseases: OA (5.2±2.4) and RA (5.1±3). HAQ was higher in OA compared to RA (1.12±0.76 vs 0.82±0.82, respectively; P=.001). Forty five percent of all subjects had depression. CONCLUSIONS The HRQoL in RA patients is poor and comparable to other chronic diseases (end-stage renal disease and diabetes mellitus). Rheumatic diseases should be considered high impact diseases and therefore should receive more attention.