Weekly home self-assessment of RAPID-4/3 scores in rheumatoid arthritis: A 6-month study in 26 patients

Abstract

Objectives: To investigate whether weekly determination of Routine Assessment of Patient Index Data (RAPID) scores 3 and 4 in patients with rheumatoid arthritis (RA) improved the assessment of disease activity and detected additional activity peaks (predictive of additional structural damage). Methods: Each week for 6 months, 26 patients with RA completed the patient-reported outcome questionnaires RAPID-3 and RAPID-4. During the study period, the treatment regimen for RA remained unchanged in 23 of the 26 patients. Results: RAPID-3 was as informative as RAPID-4. Mean values were 3.85 ± 1.66 (range: 0.72-6.85) and 3.43 ± 1.57 (range: 0.81-6.77), respectively. The areas under the RAPID-3 score curves plotted using only the first and last weeks or all the weeks showed a statistically significant difference in 19 (73%) of the 26 patients. The difference between the highest and lowest RAPID-3 scores was greater than the clinically significant threshold of 1.2 in all 26 patients (mean difference: 2.95 ± 0.71; range: 1.6-5.5). In 13 patients, the RAPID-3 score detected one (one patient) or several (12 patients) activity peaks. Among RAPID-3 score components, the visual analog scale (VAS) pain score had the greatest influence (37% of the total score), followed by the VAS disease-activity score (36%) then by the multidimensional Health Assessment Questionnaire score (27%). Scores were not influenced by patient mood at questionnaire completion. Conclusion: Self-evaluation at home using the RAPID-3 score provides additional information that should improve the accuracy of RA monitoring between physician visits and that may help to optimize visit scheduling. © 2010 Société française de rhumatologie.