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Assessing health-related quality of life in hand osteoarthritis: a literature review

Background Hand osteoarthritis (HOA) is a common disease that affects up to 40% of adults and may severely impair their health-related quality of life (HRQL). Objectives To assess how HRQL has been evaluated in HOA, focusing on a comparison of HRQL impairment in HOA and rheumatoid arthritis (RA), differences between erosive and non-erosive HOA and differences between OA of the thumb base (TB) and interphalangeal (IP) OA. Methods A systematic review of the literature. Results The authors screened 167 articles and retained 33. The outcome subsets usually reported were pain, function and stiffness. Overall HRQL was rarely assessed and the tools used differed greatly. Aesthetic damage was never studied in published articles, although this is a major complaint in daily practice. Three articles compared symptomatic HOA and RA; whereas pain and subjective health did not differ significantly, there is conflicting evidence of the difference between disability and stiffness between these groups. Two papers compared erosive and non-erosive HOA and found divergent elements concerning functional impairment; patients with erosive HOA reported more aesthetic damage. Three papers compared TB and IP OA with divergent results in terms of pain and function. Conclusion Overall HRQL is a broad concept involving domains beyond pain, function and stiffness. Few data are presently available on HOA, but it seems to have almost as great an impact as RA on HRQL. Further studies on HRQL in patients with HOA are required. Aesthetic damage should also be assessed with specifically designed tools.