Objectives: This study aimed to investigate the gender-specific factors influencing health-related quality of life (HRQoL) among rheumatoid arthritis (RA) patients within biopsychosocial framework and the interacting effects of these factors.
Methods: A prospective multi-centre cross-sectional study was conducted. Binary logistic regression and subsequent stratified analyses were used to analyse the determinants of HRQoL among RA patients and how they interacted.
Results: Female patients (83.85%) exhibited earlier onset (45.68 vs. 50.85 years), longer disease duration (60.00 vs. 36.00 months), lower Clinical Disease Activity Index (CDAI) (19.00 vs. 22.00), and less glucocorticoid use (39.55% vs. 47.75%). Multivariable analysis suggested that better HRQoL was linked to urban residence and higher education. Worse HRQoL was related to older age at onset, higher financial burden, glucocorticoid use, elevated CDAI, irregular follow up, longer follow-up intervals, comorbidities, anxiety/depressive symptoms, poor sleep satisfaction, and fatigue. Stratified analysis revealed significant interactions among CDAI and financial burden, anxiety/depressive symptoms and sleep satisfaction.
Conclusions: These findings highlight the biopsychosocial factors affecting HRQoL, emphasising the need for gender-specific strategies and targeted interventions focusing on financial burden, anxiety/depressive symptoms and sleep satisfaction in RA patients with moderate-to-high disease activity.