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Rheumatologists Underestimate the Patients Ability to Work

ir respective scores were not shared.

The rheumatologists overestimated the degree of functional disability in 154, or 69 percent, of the 223 the patients. However, they were significantly more accurate at determining the degree of physical limitations in patients with less severe disease.

The reasons for the overestimation are unclear, but may include empathy and suggest that even patients with advanced rheumatoid arthritis adapt their activities to the progression of the chronic disease, Dr. Carter said. We tend to associate visible joint deformities with incapacitated function, but patients may actually be more capable than we think.

Rheumatologists typically determine functional disability based on the patients examination and medical history, but these impressions during routine care are inadequate, Dr. Carter said.

The study points to the need for a formal, standardized evaluation, such as the HAQ-DI. It needs to be reimbursable and include input from physical and occupational therapists who could add valuable insight to the process of evaluating disability, he added.

Rheumatoid arthritis affects about 2.1 million Americans, or 1 percent of the population. Over the last decade new drugs have revolutionized the treatment of this debilitating inflammatory disease, but nearly all patients with rheumatoid arthritis eventually develop some degree of work or daily lifestyle disability, often severe.


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