Disease-specific patient-reported outcome (PRO) tools would be useful in the management of a number of rheumatologic conditions, including rheumatoid arthritis (RA), psoriatic arthritis, and systemic lupus erythematosus (SLE). The challenge has been to incorporate validated disease-specific PRO measures into practical use in patient care. Ideally, the PRO tool would be one that could be easily integrated during the office or clinic check-in process that would not require input from healthcare personnel or additional administrative processes. The Multidimensional Health Assessment Questionnaire (MDHAQ) is such a PRO tool that has been successfully used for a number of rheumatologic conditions, including for RA. Similarly, the Routine Assessment of Patient Index Data (RAPID3) can be quickly calculated from the MDHAQ. To test the value of MDHAQ and RAPID3 in patients with SLE, Annapureddy and colleagues (Abstract 188) compared RAPID3 and LupusPRO, a validated, disease-specific PRO tool for SLE, in patients with SLE who were seen during usual care.
A total of 78 patients with SLE completed both MDHAQ and LupusPRO during a routine office visit. At these visits, SLE disease activity was assessed using standard Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index and Physician’s Global Assessment scores. LupusPRO domain scores for 8 health-related quality-of-life (HRQOL) scales and 4 non-HRQOL scales were compared with RAPID3 scores that were stratified by 4 disease severity categories (ie, remission, low severity, medium severity, and high severity).
Of the 12 LupusPRO domains, 7 differed significantly in patients in the 4 RAPID3 disease severity categories, including lupus symptoms, cognition, physical health, pain/vitality, emotional health, body image, and desires/goals. Conversely, 5 of the 12 LupusPRO domains did not differ in the 4 RAPID3 disease severity categories, including procreation, lupus medications, social support, coping, and satisfaction with treatment. Moreover, the composite HRQOL LupusPRO scores differed significantly in the RAPID3 disease severity categories, although the composite non-HRQOL scores did not differ. It appears from these data that the RAPID3 correlates well with LupusPRO-HRQOL domains and can be used as a PRO tool for measuring HRQOL in patients with SLE in clinical settings and may add information that is of value in managing SLE in these patients. As RAPID3 is a generic tool, it may be easily integrated into busy clinical practices without overburdening clinic/office processes and resources.