Quantifiable fatigue scores can be collected using a brief patient questionnaire with no additional work for the physician and minimal intrusion into the clinical work flow; additionally, fatigue can be differentiated among various diseases, according to the findings of a study presented at the European League Against Rheumatism Annual European Congress of Rheumatology.
The multidimensional health assessment questionnaire (MDHAQ) was used to quantify fatigue in a group of 613 patients comprised of 173 patients with rheumatoid arthritis (RA), 199 patients with osteoarthritis (OA), 146 patients with systemic lupus erythematosus (SLE) and 94 patients with fibromyalgia (FM). Participants responded to questions on the two-page questionnaire, including an assessment of 10 activities of daily living, three 0 to 10 VAS for pain, the patient global estimate, a 60-symptom checklist, questions about fatigue and demographic data. All patients completed the questionnaire in about 5 minutes to 10 minutes in the waiting area prior to visitation with a rheumatologist at a single clinic.
The RAPID 3 form was used to score the MDHAQ replies using a sum of three scores for pain, function and patient global estimate. The researchers calculated the median scores for fatigue in all four patient groups, which were compared using the Kruskall-Wallis one-way analysis of variance. Possible associations between other MDHAQ scores and fatigue were explored mathematically.
Patients with FM had the highest fatigue scores, which varied significantly from the scores from patients with RA, OA and SLE. Scores for function, patient global estimate, RAPID 3, symptoms and other scores were also significantly different in patients with FM compared with patients with the other three diseases, according to the researcher.
A strong correlation was seen between fatigue scores and function, patient global estimate and pain in all patients, but at lower levels in patients with OA and FM, suggesting the association seen in RA and SLE may be related to inflammation, the researchers reported. – by Shirley Pulawski
Nikiphorou E, et al. Paper #THU0310. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.
Disclosure: The researchers report no relevant financial disclosures.