Quality of Life Linked to Treatment Satisfaction; Sociodemographic Factors in Patients With RA

Health-related quality of life and treatment satisfaction are often used to improve treatment outcomes as well as clinical care.

Health-related quality of life (HRQoL), which is likely affected by sociodemographic and clinical characteristics, was associated with treatment satisfaction in patients with rheumatoid arthritis (RA), according to a study published in BMC Rheumatology.1

“In clinical and policy research, the concepts of treatment satisfaction and HRQoL are commonly used to improve pharmaceutical care and treatment outcomes, [with] higher patient treatment satisfaction correlated with improved HRQoL,” investigators explained. “HRQoL also refers to self-reported physical and mental health measures influenced by individuals’ attitudes, experiences, expectations, and perceptions.”

In this multicenter cross-sectional study, conducted between July and October 2018 in Palestine, investigators interviewed adult patients (aged 18 years or older) with an RA diagnosis to analyze HRQoL and treatment satisfaction using the 36-Item Short Form Health Survey (SF-36) and Treatment Satisfaction Questionnaire for Medication (TSQM). Demographics, age, disease duration, sex, marital status, employment status, education information, disease activity, income, residency, comorbidities, and medications were collected via a questionnaire.

Of the 1042 patients referred to rheumatology clinics Northern West Bank, Palestine, 281 patients were included in the study. Worse HRQoL scores and low treatment satisfaction were associated with several sociodemographic and clinical characteristics.

The physical component summary (PCS) was positively associated with educational background (p = 0.009), with those completing junior and senior high school achieving higher scores (50.0 [35.0–60.0] and 50.0 [30.0–70.0], respectively). Additionally, social functioning significantly increased with education (p = 0.016). Other factors included income and employment (p < 0.001). However, PCS was negatively associated with age (p < 0.001), disease activity, disease duration, and the total number of medications a patient is currently prescribed.

The mental component summary (MCS) was negatively associated with the total number of comorbid diseases and disease activity, with the number of comorbidities negatively associated with effectiveness. Those who reported 0-1 comorbid diseases had a higher median than others (61.1 [55.6–72.2] and 61.1 [50.0–77.8], respectively; p = 0.006).

HRQoL, measured by TSQM, subscales were associated with treatment satisfaction. TSQM focused on effectiveness, side effects, convenience, and overall satisfaction. Side effects were positively associated with household income (p = 0.016).

A modest positive correlation was observed between all HRQoL subscales and treatment satisfaction domains, with effectiveness from (0.263–0.384), side effects (0.273–0.458), convenience (0.294–0.337), and all-over satisfaction (0.391–0.456).

Data, collected from face-to-face interviews, ensures complete data derived from a sample from all hospitals in northern Palestine, thus creating a database for patients with RA in the area. It is also the first cross-sectional study in the area to explore HRQoL and medication satisfaction among this patient population.

However, the sample size, taken from 4 hospitals in the West Bank, was relatively small, thus reducing generalizability and increasing the risk of false-negative findings. Further, the cross-sectional study design hinders casual relation. Disease activity and marital status were not analyzed, which would have better evaluated the patient’s situation and their mental health. Lastly, the medication dosages were not reported and investigators did not utilize multivariate analysis.

“These findings have important implications: the importance of the role of the multidisciplinary team in educating patients about their disease, medications, and their adverse effects. It is also important to apply a multidisciplinary approach that aims to improve the physical and psychological health of the patient,” investigators concluded. “These interventions will provide individualized management through the rheumatologist and clinical pharmacists, psychologists, physiotherapists, etc.”


Abu Hamdeh H, Al-Jabi SW, Koni A, Zyoud SH. Health-related quality of life and treatment satisfaction in Palestinians with rheumatoid arthritis: a cross-sectional study. BMC Rheumatol. 2022;6(1):19. Published 2022 Apr 6. doi:10.1186/s41927-022-00251-5