“The observations support the suggestion that fatigue is an independent measure of outcome and should be considered for inclusion as a core outcome measure in RA,” conclude researchers who were led by Patricia Minnock, an advanced nurse practitioner at Our Lady’s Hospice in Dublin, Ireland. “Moreover, this study provides evidence that fatigue measurement captures information that contributes to disease management in RA.”
In the new study, 49 patients who were referred to a rheumatology clinic had their fatigue levels assessed at baseline and 3 months after TNF-blockade was initiated. The research team measured fatigue via an 11-point numeric rating scale (NRS), and determined sensitivity to change compared with current core set outcome measures by calculating the standardized response mean (SRM).
At baseline, mean fatigue scores were 6.7, and at 3 months, fatigue scores had fallen to 4.3, the study showed. Fatigue was ranked third for relative sensitivity to change as shown by SRM. Pain and tender joint count ranked one and two, respectively. The relative independent variance in fatigue of 22% was higher than that of the core set of outcome measures, the study showed.
Translating research into practice: measure fatigue along with pain and tender and swollen joints
“The amount of information provided by fatigue was proportionate to that of the core set variables, particularly total joint count, pain and swollen joint count [and] measuring fatigue provided additional information that is essential to the understanding of disease outcomes from the patients perspective,” the researchers conclude.
Reference
1. Minnock P, Kirwan J, Bresnihan B. Fatigue is a reliable, sensitive and unique outcome measure in rheumatoid arthritis. Rheumatology. [epub ahead of print Sept. 22, 2009].
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