Quality of life, sleep and rheumatoid arthritis (QUASAR): a protocol for a prospective UK mHealth study to investigate the relationship between sleep and quality of life in adults with rheumatoid arthritis

BMJ Open. 2018 Jan 26;8(1):e018752. doi: 10.1136/bmjopen-2017-018752.

Abstract

Introduction: People with rheumatoid arthritis (RA) frequently report reduced health-related quality of life (HRQoL), the impact one's health has on physical, emotional and social well-being. There are likely numerous causes for poor HRQoL, but people with RA have identified sleep disturbances as a key contributor to their well-being. This study will identify sleep/wake rhythm-associated parameters that predict HRQoL in patients with RA.

Methods and analysis: This prospective cohort study will recruit 350 people with RA, aged 18 years or older. Following completion of a paper-based baseline questionnaire, participants will record data on 10 symptoms including pain, fatigue and mood two times a day for 30 days using a study-specific mobile application (app). A triaxial accelerometer will continuously record daytime activity and estimate evening sleep parameters over the 30 days. Every 10 days following study initiation, participants will complete a questionnaire that measures disease specific (Arthritis Impact Measurement Scale 2-Short Form (AIMS2-SF)) and generic (WHOQOL-BREF) quality of life. A final questionnaire will be completed at 60 days after entering the study. The primary outcomes are the AIMS2-SF and WHOQOL-BREF. Structural equation modelling and latent trajectory models will be used to examine the relationship between sleep/wake rhythm-associated parameters and HRQoL, over time.

Ethics and dissemination: Results from this study will be disseminated at regional and international conferences, in peer-reviewed journals and Patient and Public Engagement events, as appropriate.

Keywords: epidemiology; rheumatology; sleep medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affect
  • Arthritis, Rheumatoid / complications*
  • Fatigue / psychology
  • Humans
  • Mass Screening / methods*
  • Mobile Applications*
  • Pain / psychology
  • Prospective Studies
  • Psychiatric Status Rating Scales
  • Quality of Life*
  • Research Design
  • Severity of Illness Index
  • Sleep Wake Disorders / epidemiology*
  • Surveys and Questionnaires
  • Telemedicine
  • United Kingdom