Depression, Anxiety and Quality of Life of Patients with Rheumatoid Arthritis at the Korle Bu Teaching Hospital

Abstract

Introduction: Depression and anxiety may affect quality of life (Qol) and levels of medication adherence in patients with rheumatoid arthritis. Very little data exist on the subject in sub-Saharan Africa. Objective: To identify the symptoms of depression and anxiety among patients with rheumatoid arthritis and assess the associations among depression, anxiety, adherence and quality of life. Methods: A hospital-based cross-sectional quantitative study was carried out on 93 patients with rheumatoid arthritis at the Korle-Bu Teaching Hospital in Ghana. The Hospital Anxiety and Depression Scale, EQ-5D-5L and Morisky-Green-Levine scale were used to measure depression and anxiety, QoL and adherence respectively. Data were analysed using Stata 15. Simple linear regression, logistic regression and chi square were used to assess associations between variables. Results: Depression and anxiety prevalence was found to 20.4% and 29.0% respectively. Adherence to drug regimen among respondents was 62.4%. The mean EQ5D index and EQVAS measured were 0.71 ± 0.13 and 70.10 ± 18.33 respectively. The median EQ5D index and EQVAS were 0.71 with IR of 0.147(0.653-0.800) and 70 with IR of 30(55-85) respectively. Although initial analysis found significant association between anxiety and depression and quality of life after adjustments were done these were found not to be significant. Comorbid hypertension and age were found however to affect quality of life and adherence respectively. Conclusion: The prevalence of depression and anxiety are high in patients with rheumatoid arthritis. The disease affects quality of life of sufferers negatively. There is therefore the need to actively seek and manage these accordingly to improve clinical outcome. Keywords: Rheumatoid Arthritis, Depression, Anxiety, HADS, Quality of Life, Adherence.