It is feasible to screen for important RA co-morbidities using patient completed questionnaires

Author(s): Rosemary Waller & Lyn Williamson

Background: To study the feasibility of pre-consultation questionnaires to screen for Rheumatoid Arthritis (RA) co-morbidities compared with face-to-face consultation. Methods and findings: Postal questionnaires were sent to all RA patients on our electronic database. Four domains were studied: Gastrointestinal (GI) symptoms, Cardiovascular (CVS) symptoms and risk factors; Foot; Anxiety and depression (Hospital Anxiety and Depression Scores (HADS)). Patients were then reviewed clinically, with a full history and examination undertaken and HAQ, DAS and QRISK2 scores were calculated for each patient. 597 questionnaires were sent, 301 (50%) completed and 129 patients were reviewed in clinic. The mean DAS score was 3.04. 32% of responders reported daily GI symptoms, with no extra symptoms of concern elicited at clinic review in any patient. 49% patients had high CVS risk as calculated by QRISK2. 5% patients assessed as low CVS risk by our questionnaire were re-categorised as high risk by QRISK2. 89% of patients reported foot symptoms in the past week. Mean foot score was 4/10 with correlation co-efficient 0.63 between postal and clinical scores. The mean anxiety score was 7.8 with 49% patients scoring 8 or more. The mean depression score was 9.3 with 64% patients scoring 8 or more. Conclusion: Pre clinic screening by questionnaire is a feasible way of identifying comorbidities. We found a high rate of co-morbidities in our RA population.

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