4.0 Article

Cluster analysis identifies unmet healthcare needs among patients with rheumatoid arthritis

Journal

SCANDINAVIAN JOURNAL OF RHEUMATOLOGY
Volume 51, Issue 5, Pages 355-362

Publisher

TAYLOR & FRANCIS LTD
DOI: 10.1080/03009742.2021.1944306

Keywords

-

Categories

Funding

  1. Finnish Research Foundation for Rheumatic Diseases
  2. Academy of Finland [331671]
  3. FOREUM Foundation for Research in Rheumatology
  4. Academy of Finland (AKA) [331671, 331671] Funding Source: Academy of Finland (AKA)

Ask authors/readers for more resources

The study found that the majority of RA patients had favorable outcomes and low costs, while a large group of patients were characterized by chronic pain, disability, and fatigue not directly linked to disease activity. The highest healthcare costs were associated with high disease activity or comorbidities.
Objective: To identify the patterns of healthcare resource utilization and unmet needs of persistent disease activity, pain, and physical disability in rheumatoid arthritis (RA) by cluster analysis. Method: Patients attending the Jyvaskyla Central Hospital rheumatology unit, Finland, were, from 2007, prospectively enrolled in a clinical database. We identified all RA patients in 2010-2014 and combined their individual-level data with well-recorded administrative data on all public healthcare contacts in fiscal year 2014. We ran agglomerative hierarchical clustering (Ward's method), with 28-joint Disease Activity Score with three variables, Health Assessment Questionnaire index, pain (visual analogue scale 0-100), and total annual health service-related direct costs (euro) as clustering variables. Results: Complete-case analysis of 939 patients derived four clusters. Cluster C1 (remission and low costs, 550 patients) comprised relatively young patients with low costs, low disease activity, and minimal disability. C2 (chronic pain, disability, and fatigue, 269 patients) included those with the highest pain and fatigue levels, and disability was fairly common. C3 (inflammation, 97 patients) had rather high mean costs and the highest average disease activity, but lower average levels of pain and less disability than C2, highlighting the impact of effective treatment. C4 (comorbidities and high costs, 23 patients) was characterized by exceptionally high costs incurred by comorbidities. Conclusions: The majority of RA patients had favourable outcomes and low costs. However, a large group of patients was distinguished by chronic pain, disability, and fatigue not unambiguously linked to disease activity. The highest healthcare costs were linked to high disease activity or comorbidities.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.0
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available