Time to DMARD (Disease-Modifying Anti-Rheumatic Drug) Treatment and Actual Work Limitation of Patients With Rheumatoid Arthritis in Turkey

• Evaluation of Disease Duration: Time From Diagnosis to Disease-Modifying Anti-Rheumatic Drug Treatment in Rheumatoid Arthritis [ Time Frame: Day 1 ]
  The time elapsed from diagnosis of rheumatoid arthritis to initiation of treatment with disease-modifying anti-rheumatic drugs (DMARDs).
  
  

• Work Limitation: Health Assessment Questionnaire-Disability Index (HAQ-DI) [ Time Frame: Day 1 ]
  The HAQ-DI measures physical function by assessing the ability to perform daily living tasks. Each task is rated from 0 (no difficulty) to 3 (unable to do). The total score ranges from 0 to 3. Higher scores indicate impairment.
  
  
• Work Limitation: Work Productivity and Activity Impairment (WPAI) Questionnaire [ Time Frame: Day 1 ]
  The WPAI evaluates the ability to work and perform regular activities. The scale yields 4 types of scores (range 0 to 100): Absenteeism (work time missed); Presenteeism (impairment at work/reduced on-the-job effectiveness); Work Productivity Loss (overall work impairment/absenteeism plus presenteeism); and Activity Impairment. Higher scores indicate impairment.
  
  
• Evaluation of Global Rheumatoid Arthritis Severity Scale [ Time Frame: Day 1 ]
  Global rheumatoid arthritis severity was assessed by asking the participants to consider all the ways their rheumatoid arthritis affected them and to rate how they were doing on a scale of 0 (very well) to 10 (very poor).
  
  
• Evaluation of Disease Activity Score 28 (DAS28) [ Time Frame: Day 1 ]
  The DAS28 index measures disease activity in rheumatoid arthritis and is derived from the number of swollen/tender joints, laboratory tests of inflammation, and participant assessment of global health (by marking a 100 mm line from "very good" to "very bad"). A higher score indicates worse control of disease. A DAS28 less than 3.2 indicates low disease activity and a DAS28 greater than 5.1 indicates high disease activity.
  
  
• Evaluation of Visual Analog Scale (VAS) for Pain and Fatigue [ Time Frame: Day 1 ]
  Participants rated their pain and fatigue using a visual analog scale from 0 to 10, where 10 was the worst case.
  
  
• Number of Disease Modifying Anti-Rheumatic Drugs [ Time Frame: Day 1 ]
  The number of disease-modifying anti-rheumatic drugs (DMARDs) that participants were taking to treat their rheumatoid arthritis.
  
  
• Biologics Usage [ Time Frame: Day 1 ]
  Biologic treatments participants were taking for their rheumatoid arthritis.
  
  
• Stiffness Duration [ Time Frame: Day 1 ]
  Participants' duration of morning joint stiffness.
  
  
• Number of Comorbidities [ Time Frame: Day 1 ]
  Number of comorbid (coexisting) medical conditions of the study participants.
  
  
• Rheumatoid Factor [ Time Frame: Day 1 ]
  Rheumatoid factor test results.
  
  
• Anti-cyclic Citrullinated Peptide [ Time Frame: Day 1 ]
  Anti-cyclic citrullinated peptide (anti-CCP) test results.
  
  
• Sedimentation Rate [ Time Frame: Day 1 ]
  The erythrocyte (red blood cell) sedimentation rates of study participants were assessed.
  
  
• Number of Deformities at Inspection [ Time Frame: Day 1 ]
  The number of joint deformities of the study participants.
  
  
• Evaluation of Rheumatoid Arthritis Treatments Duration [ Time Frame: Day 1 ]
  Time elapsed from onset of symptoms to diagnosis of rheumatoid arthritis (that is, from the first rheumatoid arthritis-related symptoms to diagnosis by a related specialist) and the time elapsed from diagnosis with rheumatoid arthritis to initiation of anti-tumor necrosis factor (anti-TNF) treatment.
  
  

This post marketing observational study will be conducted in cross-sectional, non-interventional, multi-center format in Turkey. As this is a post marketing observational study, Abbott is not involved in the product supply since the drug is being used according to the approved marketing label and is to be prescribed by the physician under usual and customary practice of physician prescription.

Subjects will be recruited from rheumatology outpatient clinics of university hospitals and/or private offices.

Patients diagnosed with rheumatoid arthritis who had received at least one disease-modifying anti-rheumatic drug, who are already employed at a paid work and able to provide disease history data will be included.

Patient data will be collected with a single visit. During the single visit, all required demographic and clinical data will be recorded on the case report forms by the investigators and every subject will be asked to fill out the Work Productivity and Activity Impairment questionnaire and the Health Assessment Questionnaire - Disability Index.