Oral Analgesics and Pain Self-Efficacy Predict Quality of Life in RA

The use of oral analgesics and pain self-efficacy scores are independent predictors of quality of life (QoL) in patients with rheumatoid arthritis (RA), according to the results of a cross-sectional study published in Pain Research and Management.

Disease activity in RA is often assessed using a combined disease activity score in 28-joints and levels of C-reactive protein (DAS28-CRP). However, previous studies have shown that despite achieving remission, 12.5% of patients with RA continue to report clinically significant pain, which may affect their QoL.

To determine the variables that influence QoL in RA, data from 85 patients with RA (85.1% women) were analyzed. The mean age of participants was 63.0±12.3 years and mean disease duration was 140.1±116.5 months. The QoL was measured using the European Quality of Life questionnaire. Potential influencing variables included the presence of neuropathic pain, as measured by the painDETECT questionnaire (PDQ); the confidence that the patient can perform activities despite pain, as measured by the pain self-efficacy questionnaire (PSEQ); and the degree of catastrophic thinking regarding pain, as measured by the pain catastrophizing scale (PCS).

The QoL was positively correlated with PSEQ scores (r=0.414; P <.0001) and negatively correlated with disease duration (P =.001), PDQ scores (P =.01), PCS scores (P =.003), the use of oral analgesics (P =.001), and the use of oral steroids (P =.032). In a multiple regression analysis, the use of oral analgesics and PSEQ scores independently predicted QoL (β=-0.248 and β=0.233, respectively; P <.05 for both).

Overall, results from the study indicated that there were multiple factors that influenced the QoL in patients with RA in remission. Specifically, the use of oral analgesics and PSEQ scores were particularly strongly correlated with QoL.

Study limitations included the inclusion of a small sample size, with a low number of men, the single-center nature of the study, and the exclusion of ankle and foot joints and less stringent remission criteria inherent in the DAS28-CRP method of RA assessment.

Researchers concluded, “…various pain management strategies, including surgical treatment, may be considered for the treatment of RA. Furthermore, the PSEQ may be included in the assessment of the efficacy of RA treatments.”

Reference

Hashimoto A, Sonohata M, Mawatari M. The use of oral analgesics and pain self-efficacy are independent predictors of the quality of life of individuals with rheumatoid arthritis. Pain Res Manag. Published online July 23, 2020. doi:10.1155/2020/7409396