Weekly home self-assessment of RAPID-4/3 scores in rheumatoid arthritis: a 6-month study in 26 patients

Joint Bone Spine. 2010 Dec;77(6):582-7. doi: 10.1016/j.jbspin.2010.08.009.


Objectives: To investigate whether weekly determination of Routine Assessment of Patient Index Data (RAPID) scores 3 and 4 in patients with rheumatoid arthritis (RA) improved the assessment of disease activity and detected additional activity peaks (predictive of additional structural damage).

Methods: Each week for 6 months, 26 patients with RA completed the patient-reported outcome questionnaires RAPID-3 and RAPID-4. During the study period, the treatment regimen for RA remained unchanged in 23 of the 26 patients.

Results: RAPID-3 was as informative as RAPID-4. Mean values were 3.85±1.66 (range: 0.72-6.85) and 3.43±1.57 (range: 0.81-6.77), respectively. The areas under the RAPID-3 score curves plotted using only the first and last weeks or all the weeks showed a statistically significant difference in 19 (73%) of the 26 patients. The difference between the highest and lowest RAPID-3 scores was greater than the clinically significant threshold of 1.2 in all 26 patients (mean difference: 2.95±0.71; range: 1.6-5.5). In 13 patients, the RAPID-3 score detected one (one patient) or several (12 patients) activity peaks. Among RAPID-3 score components, the visual analog scale (VAS) pain score had the greatest influence (37% of the total score), followed by the VAS disease-activity score (36%) then by the multidimensional Health Assessment Questionnaire score (27%). Scores were not influenced by patient mood at questionnaire completion.

Conclusion: Self-evaluation at home using the RAPID-3 score provides additional information that should improve the accuracy of RA monitoring between physician visits and that may help to optimize visit scheduling.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Affect
  • Aged
  • Arthritis, Rheumatoid / diagnosis
  • Arthritis, Rheumatoid / physiopathology
  • Arthritis, Rheumatoid / psychology
  • Arthritis, Rheumatoid / therapy*
  • Diagnostic Self Evaluation*
  • Health Status Indicators*
  • Home Care Services*
  • Humans
  • Joints / pathology
  • Joints / physiopathology
  • Middle Aged
  • Pain Measurement
  • Patient Participation
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires
  • Time Factors