Quality-of-Life Considerations With Respect to Arthritis and Nonsteroidal Anti-inflammatory Drugs

This article first presents a hierarchical general quality-of-life framework, beginning with global “outcome” and progressing through dimensions, subdimensions, components, and finally to specific variables. Second, the Health Assessment Questionnaire (HAQ) is described as an example of a set of instruments designed to assess such a framework. A simple visual analog scale, which was incorporated into the HAQ in 1980 and which ranks the status of health from “very poor” to “very well,” has been shown to correlate strongly with traditional quality-of-life instruments, such as the Torrance “Feeling Thermometer.” Finally, the requirement for a side-effect index to assess quality of life related to different drug therapies is discussed. Comparative drug adverse event profiles are highlighted, a side-effect index presented, and some preliminary results and conclusions outlined. With drugs used for the treatment of rheumatic diseases, adverse events have been shown to vary widely. Indeed, the differences in side-effects are often 2–3-fold between drugs of the same class. Furthermore, the incidence of adverse events related to the use of many nonsteroidal anti-inflammatory drugs has been shown to be greater than that seen with a number of disease-modifying antirheumatic drugs.