Monitoring outcomes of arthritis and longitudinal data collection using patient questionnaires in routine care

Abstract

At the present time, clinical decisions in routine rheumatology practice generally are based on qualitative impressions, rather than on quantitative data, which might lead to improved information for clinical decisions. Patient questionnaires are the quantitative tools whereby rheumatologists have to monitor their patients’ health status and response to therapy. The health assessment questionnaire (HAQ) and its derivatives have been shown to be the best predictors of functional and work disability, costs, joint replacement surgery, and mortality; they are as good as and usually better predictors than joint counts, radiographs, and laboratory tests. Yet, patient questionnaires, which can be used in all rheumatic diseases including osteoarthritis, systemic lupus erythematosus, fibromyalgia, scleroderma, and ankylosing spondylitis, are not included in routine care by most rheumatologists. Every encounter of a patient with a rheumatologist provides an opportunity to collect data. Data that are feasible to collect in clinical care provide the only way to assess quantitatively how our patients are doing. If data are not collected and recorded, an opportunity is lost forever. Rheumatologists would find it valuable to adapt questionnaires to the care they provide for all their patients, to document and improve the care they provide, and add quantitative data to standard clinical care.