Open Access Rheumatology: Research and Reviews (Jun 2020)
Functional Disability and Its Determinants in Ecuadorian Patients with Rheumatoid Arthritis
Abstract
Maria Intriago, Genessis Maldonado, Roberto Guerrero, Mario Moreno, Letty Moreno, Carlos Rios Rheumatology Department, Universidad Espiritu Santo, Guayaquil, EcuadorCorrespondence: Genessis Maldonado Email [email protected]: Disability in RA is associated with loss of workdays, greater use of health resources and a higher prevalence of depression. The purpose of this study was to determine the prevalence of functional disability and the factors associated with it.Methods: A cross-sectional study was carried out during January–June 2019 at a rheumatology clinic in the city of Guayaquil. Patients with pre-established RA were included. Functional disability was measured using the HAQ-DI. Data were analyzed using the statistical program SPSS v22. We compared characteristics between patients with and without disability using Student’s t-test and chi-square. A multiple logistic regression model for functional disability was made.Results: We included 395 patients, 87.8% female and 12.2% male with a mean age of 51.4± 12 years and mean duration of disease 13.8± 7 years. Most patients had extra-articular manifestations (80.8%) and comorbidities (81.3%). The mean HAQ-DI was 0.8± 0.9, with a prevalence of disability of 26.6%. We found a statistically significant relationship between disability and female sex (p=0.018), age (p=0.020), presence of extra-articular manifestations (p=0.008), myalgia (p< 0.001) and fatigue (p< 0.001). In addition, patients with disabilities had a lower employment rate (26.7%) compared to those without disability (45.5%, p=0.001). In the multivariate logistic analysis, only depression (p=0.029), diabetes (p=0.003), SJC (p=0.001) and VAS of pain (p=0.004) were significantly related to functional disability.Conclusion: Disability affects a quarter of patients with RA. Among the determinants of disability, we found female sex, older age, grade of pain, inflammatory markers and the level of disease activity.Keywords: rheumatoid arthritis, disability, Ecuador