Besides increasing longevity, the ultimate goal of medical care is to improve patients' enjoyment of life, a concept akin to happiness. This study examined the determinants of happiness and quality of life (QoL) in patients with rheumatoid arthritis (RA)

In this observational, cross-sectional study, patients were assessed for disease activity, disease impact, personality, QoL, and happiness. Structural equation modeling estimation was used to analyze the associations between these dimensions, pursuing three hypotheses.

H1-disease activity and perceived impact of disease are negatively associated with overall QoL and happiness in patients with RA; H2-'positive' personality traits are related to happiness both directly and indirectly through perceived disease impact; H3-happiness has a mediating effect in the relation between the impact of disease and QoL.

Many studies have shown that the control of inflammation through immunosuppressive therapy has a markedly positive impact on PROs: controlling the disease process is, undoubtedly, as important to prevent long-term damage as to improve patients’ quality of life (QoL). Despite this, a sizeable proportion of patients with RA who are in remission still describe a high impact of disease and reduced QoL.

Happiness and quality of life

Data from 213 patients were analyzed. Results supported all driving hypotheses. Happiness was positively related to 'positive' personality and, to a lesser extent, negatively related to the impact of the disease.

Impact of disease, in turn, was positively related to disease activity and mitigated by 'positive' personality traits. Impact of the disease had a much stronger relationship with QoL than with happiness. Happiness mitigated the negative effect of disease impact on QoL.

Optimisation of QoL and happiness of people with RA requires effective control of the disease process and also improvement of the disease impact domains. Personality seems to play a pivotal mediating role in these relations.