Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Rheumatology and Rehabilitation

Objective: to evaluate Health Related Quality of Life (HRQoL) in Rheumatoid Arthritis (RA) patients, evaluate the effect of early treatment with Disease Modifying Anti-Rheumatic Drugs (DMARDs) on HRQoL and evaluate the effect of treatment adherence and factors affecting it. Results: RA patients had a significantly lower Physical Component Summary (PCS) score than healthy controls (P=0.001). Group A patients had significantly Lower disease activity (P = 0.001), lower MHAQ score (P = 0.001), less x-ray erosions (P = 0.001) and significantly higher PCS (P = 0.001) and Mental Component Summary (MCS) (P = 0.003) scores than group B patients. Adherent patients had significantly less disease activity (P<0.001), less joint destruction in X-ray (P=0.02) and lower MHAQ score (P<0.001) than non-adherent patients. Also PCS and MCS scores were significantly higher in adherent patients (P = 0.001 and 0.042 respectively). Factors that were associated with lower adherence rate were: younger age (P = 0.008), rural residence (P = 0.045), lack of patients{u2019} awareness about their condition (P = 0.001), fear from medication side effects (P = 0.006), lack of belief in medication effectiveness (P = 0.001), occurrence of medication side effects (P = 0.027), absence of medical insurance (P = 0.049) and difficult ambulation (P = 0.039). Conclusion: RA can enormously affect HRQoL. Early diagnosis and treatment by a rheumatologist within the first 6 months of disease onset together with adherence to DMARDs appear to significantly improve outcome and quality of life in RA patients.

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