COMMUNITY COMPONENT--PERFORMANCE LIMITATIONS IN RHEUMATOID ARTHRITIS PATIENT

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This proposal continues a study on a cohort of rheumatoid arthritis (RA) patients in A National Study of Role Limitations among Patients with Rheumatoid Arthritis. The proposal is founded on the principle of developing more meaningful indicators of health outcomes in arthritis patients based on social role functioning. Several important results have already come from this study. the importance of employment status on depression has been shown; a valid and reliable measure of social support was developed and is being used in other arthritis studies; family and paid work roles and factors contributing to functional status in family work have been assessed. These family role indicators are being used in other research projects, as well. Finally, functional decline in RA among treated patients is a long and protracted process requiring additional years of study to reliably investigate those factors critical in delaying functional losses. This study is unique in providing NATIONAL data on an unusually broad sample of arthritis patients drawn randomly from rheumatology practices across the United States. The study will continue to follow a sample of 820 people with rheumatoid arthritis in order to: 1) describe the course of change in social role functioning among patients with rheumatoid arthritis; 2) analyze the effects of structural, clinical and contextual factors on ability to maintain functional status and social function; 3) improve the sensitivity and specificity of our measures of role autonomy and role demands. Telephone interviews will be used to collect self- reported data on sociodemographic characteristics, symptoms, physical functioning, social role functioning and emotional state. Physicians will report data on clinical disease status. Analytical strategies will include repeated measures design MANOVA, loglinear techniques in the case of categorical dependent measures and proportional hazards survival models in those cases where time to outcome can be assessed.