ArticleRheumatology (Oxford, England)2026
From disability to daily life: functional status, quality of life and work productivity in real-world inflammatory arthritis.
Article in Rheumatology (Oxford, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveInflammatory arthritis (IA) can impair physical function, health-related quality of life (HRQoL) and productivity. Associations among these domains are recognized; however, evidence quantifying them across clearly defined disability levels remains limited. This study aimed to evaluate HRQoL and productivity across functional disability levels in IA using standardized patient-reported outcome measures (PROMs).
methodsThis cross-sectional analysis included consecutive IA patients attending rheumatology clinics in Calgary/Canada, enrolled in the Rheum4U Precision Health Registry (2018-2026). The Health Assessment Questionnaire Disability Index (HAQ-DI = 0-3) assessed functional disability, categorized as no 0, mild-to-moderate (>0-1), moderate-to-severe (1-2) or severe-to-very-severe disability (2-3). EuroQol 5-Dimension 5-Level (EQ-5D-5L; utility = -0.148 to 0.948; Visual Analogue Scale [VAS] = 0-100) measured HRQoL. The Work Productivity and Activity Impairment: Specific Health Problem (WPAI: SHP) evaluated productivity. Differences across disability levels were analysed using Kruskal-Wallis tests with Dunn's post hoc comparisons and effect sizes. Minimum important difference (MID) thresholds supported the interpretation (EQ-5D-5L utility = 0.20; VAS = 9.3; productivity = 20%).
resultsOne thousand one hundred seventy-seven (1177) IA patients were included. Worsening functional disability was associated with progressively lower HRQoL and productivity (P < 0.001). Deterioration was evident starting at mild-to-moderate disability, with the moderate-to-severe disability representing a critical threshold for impairment compared with no disability (difference utility = 0.223; VAS = 25; productivity = 40%).
conclusionIn this robust real-world study using standardized PROMs, functional decline was associated with progressively worse HRQoL and productivity, with differences statistically significant and clinically meaningful. Moderate-to-severe disability appeared to mark a critical threshold. These findings underscore the importance of early identification and management of disability to prevent clinically meaningful impairments in quality of life and productivity.
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