Comparison of AIMS2-SF, WOMAC, x-ray and a global physician assessment in order to approach quality of life in patients suffering from osteoarthritis

Thomas Rosemann, Stefanie Joos, Thorsten Koerner, Joachim Szecsenyi, Gunter Laux, Thomas Rosemann, Stefanie Joos, Thorsten Koerner, Joachim Szecsenyi, Gunter Laux

Abstract

Background: Chronic diseases like osteoarthritis (OA) substantially affect different dimensions of quality of life (QoL). The aim of the study was to reveal possible factors which mainly influence general practitioners (GPs) assessment of patients' QoL.

Methods: 220 primary care patients with OA of the knee or the hip treated by their general practitioner for at least one year were included. All GPs were asked to assess patients' QoL based on the patients' history, actual examination and existing x-rays by means of a visual analog scale (VAS scale), resulting in values ranging from 0 to 10. Patients were asked to complete the McMaster Universities Osteoarthritis Index (WOMAC) and the Arthritis Impact Measurement Scale2 Short Form (AIMS2-SF) questionnaire.

Results: Significant correlations were revealed between "GP assessment" and the AIMS2-SF scales "physical" (rho = 0.495) and "symptom" (rho = 0.598) as well as to the "pain" scale of the WOMAC (rho = 0.557). A multivariate ordinal regression analysis revealed only the AIMS2-SF "symptom" scale (coefficient beta = 0.2588; p = 0.0267) and the x-ray grading according to Kellgren and Lawrence as significant influence variables (beta = 0.6395; p = 0.0004).

Conclusion: The results of the present study suggest that physicians' assessment of patients' QoL is mainly dominated by physical factors, namely pain and severity of x-ray findings. Our results suggest that socioeconomic and psychosocial factors, which are known to have substantial impact on QoL, are underestimated or missed. Moreover, the overestimation of x-ray findings, which are known to be less correlated to QoL, may cause over-treatment while important and promising targets to increase patients' QoL are missed.

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References

    1. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003;81:646–656.
    1. Mamlin LA, Melfi CA, Parchman ML, Gutierrez B, Allen DI, Katz BP, Dittus RS, Heck DA, Freund DA. Management of osteoarthritis of the knee by primary care physicians. Arch Fam Med. 1998;7:563–567. doi: 10.1001/archfami.7.6.563.
    1. van Saase JL, Vandenbroucke JP, van Romunde LK, Valkenburg HA. Osteoarthritis and obesity in the general population. A relationship calling for an explanation. J Rheumatol. 1988;15:1152–1158.
    1. Ehrlich GE. The rise of osteoarthritis. Bull World Health Organ. 2003;81:630.
    1. Abom BM, Munck AP. [Examination and treatment of musculoskeletal diseases in general practice investigated by medical audit] Ugeskr Laeger. 1997;159:6680–6683.
    1. Ethgen O, Vanparijs P, Delhalle S, Rosant S, Bruyere O, Reginster JY. Social support and health-related quality of life in hip and knee osteoarthritis. Qual Life Res. 2004;13:321–330. doi: 10.1023/B:QURE.0000018492.40262.d1.
    1. Garcia EL, Banegas JR, Perez-Regadera AG, Cabrera RH, Rodriguez-Artalejo F. Social network and health-related quality of life in older adults: a population-based study in Spain. Qual Life Res. 2005;14:511–520. doi: 10.1007/s11136-004-5329-z.
    1. Hopman-Rock M, Kraaimaat FW, Bijlsma JW. Quality of life in elderly subjects with pain in the hip or knee. Qual Life Res. 1997;6:67–76. doi: 10.1023/A:1026421629416.
    1. Chard J, Dickson J, Tallon D, Dieppe P. A comparison of the views of rheumatologists, general practitioners and patients on the treatment of osteoarthritis. Rheumatology (Oxford) 2002;41:1208–1210. doi: 10.1093/rheumatology/41.10.1208-a.
    1. Memel DS, Kirwan JR, Sharp DJ, Hehir M. General practitioners miss disability and anxiety as well as depression in their patients with osteoarthritis. Br J Gen Pract. 2000;50:645–648.
    1. Rosemann T, Korner T, Wensing M, Gensichen J, Muth C, Joos S, Szecsenyi J. Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339] BMC Public Health. 2005;5:77. doi: 10.1186/1471-2458-5-77.
    1. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.
    1. Stucki G, Meier D, Stucki S, Michel BA, Tyndall AG, Dick W, Theiler R. [Evaluation of a German version of WOMAC (Western Ontario and McMaster Universities) Arthrosis Index] Z Rheumatol. 1996;55:40–49.
    1. Meenan RF, Gertman PM, Mason JH. Measuring health status in arthritis. The arthritis impact measurement scales. Arthritis Rheum. 1980;23:146–152.
    1. Meenan RF, Mason JH, Anderson JJ, Guccione AA, Kazis LE. AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement Scales Health Status Questionnaire. Arthritis Rheum. 1992;35:1–10.
    1. Lequesne MG, Mery C, Samson M, Gerard P. Indexes of severity for osteoarthritis of the hip and knee. Validation--value in comparison with other assessment tests. Scand J Rheumatol Suppl. 1987;65:85–89.
    1. Rosemann T, Korner T, Wensing M, Schneider A, Szecsenyi J. Evaluation and cultural adaptation of a German version of the AIMS2-SF questionnaire (German AIMS2-SF) Rheumatology (Oxford) 2005
    1. Guillemin F, Coste J, Pouchot J, Ghezail M, Bregeon C, Sany J. The AIMS2-SF: a short form of the Arthritis Impact Measurement Scales 2. French Quality of Life in Rheumatology Group. Arthritis Rheum. 1997;40:1267–1274.
    1. Ren XS, Kazis L, Meenan RF. Short-form Arthritis Impact Measurement Scales 2: tests of reliability and validity among patients with osteoarthritis. Arthritis Care Res. 1999;12:163–171. doi: 10.1002/1529-0131(199906)12:3<163::AID-ART3>;2-Z.
    1. Taal E, Rasker JJ, Riemsma RP. Psychometric properties of a Dutch short form of the Arthritis Impact Measurement Scales 2 (Dutch-AIMS2-SF) Rheumatology (Oxford) 2003;42:427–434. doi: 10.1093/rheumatology/keg133.
    1. Altman R, Asch E, Bloch D, Bole G, Borenstein D, Brandt K, Christy W, Cooke TD, Greenwald R, Hochberg M, . Development of criteria for the classification and reporting of osteoarthritis. Classification of osteoarthritis of the knee. Diagnostic and Therapeutic Criteria Committee of the American Rheumatism Association. Arthritis Rheum. 1986;29:1039–1049.
    1. Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Feldman D, . The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991;34:505–514.
    1. P MC. Regression Models for Ordinal Data. Journal of the Royal Statistical Society. 1980;42:109–142.
    1. McCullagh P NJA. Generalized Linear Model. 2. London, Chapman & Hall.; 1989.
    1. Regulla DF, Eder H. Patient exposure in medical X-ray imaging in Europe. Radiat Prot Dosimetry. 2005;114:11–25. doi: 10.1093/rpd/nch538.
    1. de Bock GH, Kaptein AA, Touw-Otten F, Mulder JD. Health-related quality of life in patients with osteoarthritis in a family practice setting. Arthritis Care Res. 1995;8:88–93.
    1. van der Waal JM, Terwee CB, van der Windt DA, Bouter LM, Dekker J. The impact of non-traumatic hip and knee disorders on health-related quality of life as measured with the SF-36 or SF-12. A systematic review. Qual Life Res. 2005;14:1141–1155. doi: 10.1007/s11136-004-4599-9.
    1. Dieppe PA. Relationship between symptoms and structural change in osteoarthritis. what are the important targets for osteoarthritis therapy? J Rheumatol Suppl. 2004;70:50–53.
    1. Escalante A, del RI. How much disability in rheumatoid arthritis is explained by rheumatoid arthritis? Arthritis Rheum. 1999;42:1712–1721. doi: 10.1002/1529-0131(199908)42:8<1712::AID-ANR21>;2-X.
    1. Kee CC. Older adults with osteoarthritis. Psychological status and physical function. J Gerontol Nurs. 2003;29:26–34.
    1. Thumboo J, Chew LH, Lewin-Koh SC. Socioeconomic and psychosocial factors influence pain or physical function in Asian patients with knee or hip osteoarthritis. Ann Rheum Dis. 2002;61:1017–1020. doi: 10.1136/ard.61.11.1017.
    1. Escalante A, del RI. Epidemiology and impact of rheumatic disorders in the United States Hispanic population. Curr Opin Rheumatol. 2001;13:104–110. doi: 10.1097/00002281-200103000-00003.
    1. Taal E, Bobietinska E, Lloyd J, Veehof M, Rasker WJ, Oosterveld FG, Rasker JJ. Successfully living with chronic arthritis The role of the allied health professionals. Clin Rheumatol. 2005

Source: PubMed

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