MEASURING HEALTH STATUS DURING CLINICAL CARE

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Patient status measures appear quite useful in the prognosis and monitoring of outcomes in chronic disease. In rheumatology, functional and psychological indices derived from two-page clinical self-report questionnaires have been shown to provide meaningful clinical information. The indices have offered measurable insight into the psychosocial problems of patients that clinicians always acknowledged were of great importance, but had no simple way to assess. They have also been demonstrated to document and predict longterm functional declines, work disability, and mortality in rheumatic diseases. These self-administered questionnaires to assess patient status and clinical outcomes have been thoroughly examined for reliability and validity by various psychometric methods, and have been found valuable in many research studies. However, despite their documented value, questionnaires have not been incorporated into usual clinical care. The goal of this study is to further examine incorporating the patient's perspective into routine care and management of patients with rheumatoid arthritis (RA) through patient self-report questionnaires. A tow-page self-report questionnaire, the Activities and Lifestyle Index, to assess activities of daily living, pain, fatigue and psychological distress will be administered to all recruited patients of participating physicians at each clinical encounter. A one-page health status report will be provided to physicians for a random sample of 50% of the patients. After one year, patient and physician satisfaction, changes in treatment, and changes in clinical status will be evaluated.