Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective

Márta Péntek (), Bernadette Rojkovich, László Czirják, Pál Géher, Péter Keszthelyi, Attila Kovács, László Kovács, Zita Szabó, Zoltán Szekanecz, László Tamási, Ágnes Edit Tóth, Ilona Ujfalussy, Noémi Vártokné Hevér, Bálint Strbák, Petra Baji, Valentin Brodszky and László Gulácsi
Additional contact information
Márta Péntek: Corvinus University of Budapest
Bernadette Rojkovich: Polyclinic of the Hospital Brothers of St. John of God in Budapest
László Czirják: University of Pécs
Pál Géher: Polyclinic of the Hospital Brothers of St. John of God in Budapest
Péter Keszthelyi: Kálmán Pándy Hospital
Attila Kovács: Hospital of Hungarian State Railways
László Kovács: University of Szeged
Zita Szabó: András Jósa Hospital
Zoltán Szekanecz: University of Debrecen Medical and Health Science Center
László Tamási: Semmelweis Teaching Hospital – Szent Ferenc Hospital Division
Ágnes Edit Tóth: Flór Ferenc County Hospital
Ilona Ujfalussy: Military Hospital
Noémi Vártokné Hevér: Corvinus University of Budapest
Bálint Strbák: Corvinus University of Budapest
Petra Baji: Corvinus University of Budapest
László Gulácsi: Corvinus University of Budapest

The European Journal of Health Economics, 2014, vol. 15, issue 1, No 9, 73-82

Abstract: Abstract Some health problems are considered by many individuals as a ‘normal’ part of ageing. Our aim was to investigate whether patients with rheumatoid arthritis (RA) consider different types and levels of health losses as acceptable beyond a certain age. A multicenter cross-sectional survey was performed involving RA patients at the initiation of the first biological therapy. The EQ-5D and the Health Assessment Questionnaire Disability Index (HAQ-DI) questionnaires were used to describe domain-specific health states. Patients were asked to indicate for each domain from what age and onward (between ages 30 and 80 years in 10 year intervals) they considered moderate and severe problems acceptable or alternatively never acceptable. Seventy-seven RA patients (females 86 %, mean age 50.3, disease duration 9.1 years) completed the questionnaire. Disease activity (DAS28), EQ-5D and HAQ-DI scores were mean 6.00 (SD 0.85), 0.35 (SD 0.36), 1.48 (SD 0.66), respectively. The majority of the patients considered age 70 and beyond as acceptable to have some health problems (EQ-5D: self-care 42 %, pain/discomfort 34 %, mobility 33 %, usual activities 33 %, anxiety/depression 27 %), whilst at ages 30 and 40 as not acceptable. Severe health problems were mostly (57–69 %) considered never acceptable, except the ‘Usual activities’ domain (acceptable from age 80 by 50.6 %). The great majority of the patients (77–96 %) were younger than what they indicated as the acceptability age limit. Similar results were found for the HAQ-DI. This small experimental study suggests that RA patients consider some health problems acceptable. This acceptability is age related and varies by health areas. Further larger studies are needed to explore explanatory variables and to compare with other diseases. Owing to the impact acceptability might have on RA patients’ self-evaluation of current health state and decision-making, the topic deserves methodological improvement and further investigation.

Keywords: Health status; Rheumatoid arthritis; Acceptability; EQ-5D; HAQ-DI (search for similar items in EconPapers)
JEL-codes: I19 (search for similar items in EconPapers)
Date: 2014
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DOI: 10.1007/s10198-014-0596-2

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