Health-related Quality of Life, Treatment Satisfaction, and Associated Factors, among Patients with Rheumatoid Arthritis Attending Comprehensive Specialized Hospitals in Northwest Ethiopia, 2024: A Multicenter Cross-sectional Study

Abstract

Background: “Rheumatoid arthritis is a chronic autoimmune condition with chronic pain that progressively becomes devastating and negatively influences health-related quality of life. Patient satisfaction with treatment is a predictor of medication adherence, not only this it also affects using medication correctly despite the recent advances in treatment;” findings in this area are insufficient and contradictory. Therefore, this study aimed to assess health-related quality of life, treatment satisfaction, and associated factors among patients with rheumatoid arthritis in northwest Ethiopia in 2024 Method: A multi-center cross-sectional study was conducted among 393 rheumatoid arthritis patients attending the rheumatoid follow-up clinic of five comprehensive specialized hospitals in northwest Ethiopia from June 21 to September 20, 2024. A systematic random sampling technique was used to collect data. The Treatment Satisfaction with Medicines Questionnaire and a short-form 36 health survey were used to determine treatment satisfaction and health-related quality of life, respectively. Face-to-face interviews with respondents from selected hospitals were used to gather data. Multiple linear regression was done to identify associated factors. In addition, a preseason correlation was used to assess the association between health-related quality of life and treatment satisfaction. Statistical significance was declared as P-value <0.05 Result: 393 participants were included in the study. The mean age was 52.28(SD, 13.43). Around 75.6% were female and 56.5% were married. Around 42.7% of patients had moderate disease activity and 53.9% had comorbidities. The mean for the domain of Short-form-36 ranges from 24.7 (SD, 19.1) for role limitation due to physical problems to 49.1 (SD, 21.4) for mental health, and overall scores of treatment satisfaction were 52.8 (SD, 10.5). The summary of the physical and mental components had respective means and standard deviations of 30.7 (SD, 11.35) and 43.5 (SD, 12.01). The physical component summary was negatively associated with “being uneducated (β =-0.14, 95% CI (-4.03, -0.04), p= 0.03), high disease activity (β= -0.63, 95% CI (-20.70, -11.95), p <0.001), and unavailability of medication (β=-0.24, 95% CI (-5.23, -1.45), p= 0.001). However, being employed was positively associated (β= 0.12, 95% CI (0.08, 4.81), p = 0.04). ”While the mental component summary was negatively associated with “being obese (β=-0.18, 95% CI (-9.62, -0.45), p = 0.03), high disease activity (β=-0.55, 95% CI (-20.45, -9.95) p<0.001).” Treatment satisfaction was negatively associated with “not taking therapeutic ix | P a g e education (β=-0.14, 95% CI (-6.12,-1.54), high disease activity (β=-0.31, 95% CI (-12.64,-0.45).’’ A positive correlation existed between health-related quality of life and treatment satisfaction Conclusion: Overall, health-related quality of life was poor. Treatment satisfaction was better. The physical health-related quality of life of rheumatoid arthritis patients was affected more than the mental one. Being single, disease activity, availability of medication, obesity, and disease duration are all factors affecting the health-related quality of life and duration of disease, disease activity, unavailability of medication and therapeutic education were factors affecting treatment satisfaction. Furthermore, a positive correlation was observed between HRQoL and treatment satisfaction Keywor