Uhlig, T.; Moe, R.; Reinsberg, S.; Kvien, T.K.; Cieza, Alarcos; Stucki, Gerold
Responsiveness of the International Classification of Functioning, Disability and Health (ICF) Core Set for rheumatoid arthritis.
In: Annals of the Rheumatic Diseases, Vol. 69: pp. 879-884
Background: The comprehensive International
Classification of Functioning, Disability and Health (ICF)
Core Set for rheumatoid arthritis (RA) is a selection of 96
categories from the ICF, representing relevant aspects in
the functioning of patients with RA.
Objectives: To study the responsiveness of the ICF Core
Set for RA in rheumatological practice.
Methods: A total of 46 patients with RA (72% women,
mean (SD) age 53.6 (12.6) years, disease duration 6.3
(8.0) years) were interviewed at baseline and again after
6 months treatment with a disease-modifying antirheumatic
drug (DMARD), applying the ICF Core Set for RA
with qualifiers for problems on a modified three-point
scale (no problem, mild/moderate, severe/complete).
Patient-reported outcomes included Modified Health
Assessment Questionnaire (MHAQ) and Short-Form 36
(SF-36) health survey, and disease activity was calculated.
Responsiveness was measured as change in
qualifiers in ICF categories, and was also compared with
change in patient-reported outcomes.
Results: After 6 months of DMARD treatment,
improvement by at least one qualifier was seen in 20% of
patients (averaged across all ICF categories), 71%
experienced no change and 9% experienced worsening
symptoms. Findings were similar across the different
aspects of functioning. Mainly moderate effect sizes were
seen for 6-month changes in the ICF Core Set for RA,
especially in patients with improved health status, with
similar effect size for disease activity. The components in
the ICF Core Set for RA were only weakly associated with
patient-reported outcomes and disease activity.
Conclusions: The ICF Core Set for RA demonstrated
moderate responsiveness in this real-life setting of
patients where minor changes occurred during treatment