The British Journal of Rheumatology, Vol 36, 69-73, Copyright © 1997 by British Society for Rheumatology
DA Houssien, SP McKenna and DL Scott
Clinical measurement in rheumatoid arthritis (RA) has focused on articular
problems. Although measures like the Health Assessment Questionnaire (HAQ)
are widely used to determine functional impairment, there is a need to
determine the overall effect of RA on general health status. We evaluated
the relationship of a generic health status measure-the Nottingham Health
Profile (NHP)-to the clinical, laboratory and radiological changes in the
EULAR core data set for RA. Two hundred consecutive out-patients with RA
were recruited. Their mean age was 58.9 yr and mean disease duration 11.3
yr. Patients completed the NHP and the following assessments were made: the
EULAR Core Data Set, the duration of morning stiffness, the Disease
Activity Score (DAS), rheumatoid factor (RF) levels, and Larsen's score for
X-rays of hands and wrists. RA patients had higher scores on the NHP than
both a random population sample and a second sample of patients with a
variety of common diseases. NHP scores were not related to age or disease
duration in RA. There was little relationship between perceived distress
and the Larsen score, RF, ESR and C-reactive protein levels. Moderate
associations were seen between NHP scores and disease activity measures,
including the number of tender and swollen joints, pain and the duration of
early morning stiffness, and also with a disability measure-the HAQ. NHP
scores were highly related to disease activity measured by DAS. High DAS
scores were associated with high scores in the energy level, pain and sleep
sections of the NHP. The NHP gives relevant information about RA patients.
They have high scores for pain, physical mobility and energy level
sections, and also have high distress for sleep and emotional reactions.
ORIGINAL PAPERS
The Nottingham Health Profile as a measure of disease activity and outcome in rheumatoid arthritis
Academic Rheumatology Unit, King's College School of Medicine and Dentistry, London.
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