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Magrey M, Wei JCC, Yndestad A, Bushmakin AG, Cappelleri JC, Dina O, Deodhar A. Relationships of Work Productivity and Activity Impairment With Patient-Reported Outcomes in Ankylosing Spondylitis: Results From Two Trials. Arthritis Care Res (Hoboken) 2024; 76:359-365. [PMID: 37909386 DOI: 10.1002/acr.25267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/10/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE We examined the relationships of work productivity and activity impairment with key patient-reported outcomes (PROs) assessing pain, disease activity, and health-related quality of life (HRQoL) in patients with ankylosing spondylitis (AS). METHODS This post hoc analysis pooled available data from baseline to end of the double-blind phase of phase 2 and 3 placebo-controlled tofacitinib trials in patients with active AS. A repeated-measures longitudinal model assessed the relationships (linear or nonlinear) between Work Productivity and Activity Impairment questionnaire in Spondyloarthritis (WPAI:SpA) domains (absenteeism, activity impairment, presenteeism, and productivity loss) as outcomes and key PROs (total back pain, nocturnal spinal pain, Patient Global Assessment of Disease Activity, AS Quality of Life, EuroQol 5-Dimension 3-Level [EQ-5D-3L], and EQ-5D Visual Analog Scale [EQ-5D-VAS]) as predictors. RESULTS Data from 330 to 475 patients were available, depending on the analysis. Relationships between WPAI:SpA domains and PROs were approximately linear. The worst PRO scores were associated with a decline in patients' work capacity (measured by activity impairment, presenteeism, and productivity loss [>65%]); the best scores were associated with improvements in WPAI:SpA domains (8%-23%). Incremental PRO improvements were associated with improvement of activity impairment, presenteeism, and productivity loss. Relationships between absenteeism and PROs were the weakest, owing to absenteeism being low in the study population. CONCLUSION Evidence of linear relationships between work productivity and activity impairment with patient-reported pain, disease activity, and HRQoL was observed. Interventions to control pain and disease activity and improve HRQoL are therefore likely to improve work productivity and reduce activity impairment in patients with AS.
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Affiliation(s)
- Marina Magrey
- Case Western Reserve University and Division of Rheumatology, University Hospitals Cleveland Medical Center, Cleveland, Ohio
| | - James Cheng-Chung Wei
- Chung Shan Medical University Hospital and Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
| | | | | | | | | | - Atul Deodhar
- Oregon Health & Science University, Portland, Oregon
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2
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Polat ME, Karaaslan M, Yilmaz M, Olcucuoglu E, Sirin ME. The effect of ureteral double J stent insertion on work performance in patients undergoing endoscopic stone treatment. Cent European J Urol 2024; 77:117-121. [PMID: 38645805 PMCID: PMC11032031 DOI: 10.5173/ceju.2023.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 11/23/2023] [Accepted: 12/10/2023] [Indexed: 04/23/2024] Open
Abstract
Introduction Despite the developments in the material of the double J (DJ) stents and the production of thinner ones of desired sizes, patients continue to experience troublesome DJ stent-related symptoms in their lives. This study aimed to determine how DJ stenting affects patients' work performance after endoscopic stone surgery. Material and methods A total of 107 patients underwent placement of a ureteral stent after ureterorenoscopy (URS)/retrograde intrarenal surgery (RIRS), and only active and full-time working patients were included. All patients were asked to complete the validated Turkish version of the work performance score (WPS) questionnaire in the Ureteral Stent Symptom Questionnaire (USSQ) the day before stent removal and again one month after stent removal. Results Of the participants, 32.7% (n = 35) were female and 67.3% (n = 72) were male; the mean age was 41 (19-80) years. The workday loss had no statistically significant correlation with patient BMI, stone size, or stent indwelling time (p >0.005); however, a statistically significant negative correlation was detected with patient age (r = -0.335, p <0.001). The medians of WPSs with the stent and without the stent were 6 (3-15) and 3 (3-12), respectively (p <0.001). Conclusions Although DJ catheterization is a crucial tool for urological practice, it may increase the social and economic burden of patients due to reduced work performance and lost workdays. Therefore, limiting the duration of the DJ stent's stay and providing treatments to minimize patient symptoms will positively impact their professional lives. It would be beneficial to avoid DJ stenting in routine practice unless medically necessary.
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Affiliation(s)
- Muhammed Emin Polat
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | | | - Mehmet Yilmaz
- Department of Urology, Asklepios Klinik Triberg, Triberg, Germany
| | - Erkan Olcucuoglu
- Department of Urology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mehmet Emin Sirin
- University of Health Sciences, Dıskapi Yilidirim Beyazit Research and Training Hospital, Ankara, Turkey
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Santos-Moreno P, Parra-Padilla D, Gómez-De la Rosa F, Carrasquilla-Sotomayor M, Villarreal L, Jervis-Jálabe DS, Alvis-Zakzuk NJ. Direct Medical Costs and Healthcare Resource Utilization of Treating Patients With Two Clinical Subtypes of Axial Spondyloarthritis in Colombia. Value Health Reg Issues 2022; 32:88-94. [PMID: 36152397 DOI: 10.1016/j.vhri.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 06/22/2022] [Accepted: 08/09/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to calculate the healthcare resource utilization and direct medical costs in patients with 2 subtypes of axial spondyloarthritis (axSpA) in a rheumatic care center in Colombia. METHODS This is a retrospective cost-of-illness study. Patients with at least 1 medical consultation associated with an axSpA diagnosis between October 2018 and October 2019 were identified. Patients were classified as having radiographic (r-axSpA) or nonradiographic axSpA (nr-axSpA). Direct medical costs were calculated in Colombian pesos and expressed in American dollars using an exchange rate of 3263 Colombian pesos = 1 US dollar ($). Predictors of total direct costs were identified using a generalized linear model with gamma distribution and log-link. RESULTS A total of 162 patients with a mean age of 49.6 years (± 13.7) were included in the study. Among these, 147 (90.7%) were considered as having r-axSpA and 15 (9.3%) nr-axSpA, with mean costs of $6600 (± 6203) and $843 (± 1135), respectively (P < .001). The total direct mean cost was calculated at $6067 (± 6144) per patient. Medication costs were the main driver of total costs (97.6%, $5921), with biologic disease-modifying antirheumatic drugs accounting for nearly 92.0% ($5582) of these costs. Rheumatologist (100%) and physiatrist (64.2%) visits were the most frequently used medical service. CONCLUSIONS The economic burden associated with axSpA in the Colombian setting is substantial. There is a significant difference in direct medical costs between the r-axSpA and the nr-axSpA. Health policies aimed at the comprehensive management of nr-axSpA would have an important role in the reduction of the associated direct medical costs.
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Affiliation(s)
| | - Devian Parra-Padilla
- Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Health Technology Assessment, ALZAK Foundation, Cartagena, Colombia
| | | | | | | | | | - Nelson J Alvis-Zakzuk
- Department of Health Sciences. Universidad de la Costa, Barranquilla, Colombia; Postgraduate Program in Epidemiology, School of Public Health, University of São Paulo, São Paulo, Brazil.
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Grewal G, Polisetty T, Cannon D, Ardeljan A, Vakharia RM, Rodriguez HC, Levy JC. Alcohol Abuse, Morbid Obesity, Depression, Congestive Heart Failure, and Chronic Pulmonary Disease are Risk Factors for 90-Day Readmission After Arthroscopic Rotator Cuff Repair. Arthrosc Sports Med Rehabil 2022; 4:e1683-e1691. [PMID: 36312727 PMCID: PMC9596891 DOI: 10.1016/j.asmr.2022.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/28/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose The purpose of this study was to report the rate and causes of 90-day readmissions after arthroscopic rotator cuff repair. Methods A retrospective query from January 2005 to March 2014 was performed using a nationwide administrative claims registry. Patients and complications were identified using International Classification of Disease, Ninth Revision (ICD-9) and Current Procedural Terminology (CPT) codes. Patients who underwent arthroscopic rotator cuff repair (RCR) and were readmitted within 90 days after their index procedure were identified. Patients not readmitted represented controls. Patients readmitted were stratified into separate cohorts depending on the primary cause of readmission, which included cardiac, endocrine, hematological, infectious, gastrointestinal, musculoskeletal (MSK), neoplastic, neurological or psychiatric, pulmonary, and renal. Risk factors assessed were comorbidities comprising the Elixhauser-Comorbidity Index (ECI). Primary outcomes analyzed and compared included cause for readmission, patient demographics, risk factors, in-hospital length of stay (LOS), and costs. Pearson’s chi-square was used to compare patient demographics, and multivariate binomial logistic regression was used to calculate odds ratios (OR) on patient-related risk factors for 90-day readmissions. Results 10,425 readmitted patients and 301,625 control patients were identified, representing a 90-day readmission rate of 3.5%. The causes of readmissions were primarily related to infectious diseases (15%), MSK (15%), and cardiac (14%) complications. The most common MSK readmissions were osteoarthrosis of the leg or shoulder (24.8%) and spinal spondylosis (8.4%). Multivariate binomial logistic regression analyses demonstrated patients with alcohol abuse (OR, 1.42; P < .0001), morbid obesity (OR, 1.38; P < .0001), depression (OR, 1.35; P < .0001), congestive heart failure (OR, 1.34; P < 0.0001), and chronic pulmonary disease (OR, 1.28; P < .0001) were at the greatest risk of readmissions after RCR. Conclusions Significant differences exist among patients readmitted, and those patients who do not require hospital readmission within 90 days following arthroscopic rotator cuff repairs. Readmissions are associated with significant patient comorbidities and were primarily related to medically based complications. Level of Evidence Level III, prognostic, retrospective cohort study.
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Gravaldi LP, Bonetti F, Lezzerini S, De Maio F. Effectiveness of Physiotherapy in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis. Healthcare (Basel) 2022; 10:healthcare10010132. [PMID: 35052296 PMCID: PMC8775656 DOI: 10.3390/healthcare10010132] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/05/2022] [Accepted: 01/06/2022] [Indexed: 12/25/2022] Open
Abstract
This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = -0.37, 95% CI, -0.64; -0.11; p < 0.001, I2 = 71.25%, n = 629), and functional capacity (standardised mean difference = -0.36, 95% CI, -0.61; -0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed.
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Franco L, Sengupta R, Wade L, Cazzola D. A novel IMU-based clinical assessment protocol for Axial Spondyloarthritis: a protocol validation study. PeerJ 2021; 9:e10623. [PMID: 33569248 PMCID: PMC7845531 DOI: 10.7717/peerj.10623] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 11/30/2020] [Indexed: 01/31/2023] Open
Abstract
Clinical assessment of spinal impairment in Axial Spondyloarthritis is currently performed using the Bath Ankylosing Spondylitis Metrological Index (BASMI). Despite being appreciated for its simplicity, the BASMI index lacks sensitivity and specificity of spinal changes, demonstrating poor association with radiographical range of motion (ROM). Inertial measurement units (IMUs) have shown promising results as a cost-effective method to quantitatively examine movement of the human body, however errors due to sensor angular drift have limited their application to a clinical space. Therefore, this article presents a wearable sensor protocol that facilitates unrestrained orientation measurements in space while limiting sensor angular drift through a novel constraint-based approach. Eleven healthy male participants performed five BASMI-inspired functional movements where spinal ROM and continuous kinematics were calculated for five spine segments and four spinal joint levels (lumbar, lower thoracic, upper thoracic and cervical). A Bland-Altman analysis was used to assess the level of agreement on range of motion measurements, whilst intraclass correlation coefficient (ICC), standardised error measurement, and minimum detectable change (MDC) to assess relative and absolute reliability. Continuous kinematics error was investigated through root mean square error (RMSE), maximum absolute error (MAE) and Spearman correlation coefficient (ρ). The overall error in the measurement of continuous kinematic measures was low in both the sagittal (RMSE = 2.1°), and frontal plane (RMSE = 2.3°). ROM limits of agreement (LoA) and minimum detectable change were excellent for the sagittal plane (maximum value LoA 1.9° and MDC 2.4°) and fair for lateral flexion (overall value LoA 4.8° and MDC 5.7°). The reliability analysis showed excellent level of agreement (ICC > 0.9) for both segment and joint ROM across all movements. The results from this study demonstrated better or equivalent accuracy than previous studies and were considered acceptable for application in a clinical setting. The protocol has shown to be a valuable tool for the assessment of spinal ROM and kinematics, but a clinical validation study on Axial Spondyloarthritis patients is required for the development and testing of a novel mobility index.
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Affiliation(s)
- Luca Franco
- Department for Health, University of Bath, Bath, UK
- Centre for Analysis of Motion, Entertainment Research and Application, Bath, UK
| | - Raj Sengupta
- Royal National Hospital for Rheumatic Diseases, Bath, UK
- Department of Pharmacy and Pharmacology, University of Bath, Bath, UK
| | - Logan Wade
- Department for Health, University of Bath, Bath, UK
- Centre for Analysis of Motion, Entertainment Research and Application, Bath, UK
| | - Dario Cazzola
- Department for Health, University of Bath, Bath, UK
- Centre for Analysis of Motion, Entertainment Research and Application, Bath, UK
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Kwan YH, Kwoh SY, Phang JK, Cheen MHH, Lim KK, Wang CTM, Leung YY, Koh HL, Ostbye T, Thumboo J, Fong W. The direct and indirect costs of axial spondyloarthritis (axSpA) in Singapore. Int J Rheum Dis 2020; 23:334-341. [PMID: 31903711 DOI: 10.1111/1756-185x.13777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 11/26/2019] [Accepted: 12/02/2019] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To estimate the economic annual direct and indirect costs of axial spondyloarthritis (axSpA) in Singapore, and to identify factors associated with these costs. METHODS A retrospective, cross-sectional, Institutional Review Board-approved study was conducted. A questionnaire was administered to the patients between 2013 and 2016 from the Singapore General Hospital (SGH) spondyloarthritis registry. Direct medical costs and indirect costs were estimated using the SGH database and the human capital approach respectively. Multivariate analyses using generalized linear model with gamma distribution and a log-linked function was conducted to identify factors associated with these total, direct and indirect costs. All costs were adjusted to 2017 using the Singapore Consumer Price Index and converted to 2017 US dollars (USD) by purchasing power parity. RESULTS A total of 135 consecutive patients were included in the study, with a mean age of 40.4 ± 13.2 years. The overall annual total economic cost to society was around USD 74 790 820, with annual direct cost being the main component of total cost (90.8%). Annual direct cost was around USD 67 931 457, while annual indirect cost was around USD 6 855 951. Presence of extra-spinal symptoms (ever) was associated with an increase in total and direct costs. Higher education level and Patient Global Assessment were associated with an increase in indirect costs. Lack of employment was associated with a decrease in indirect costs. CONCLUSION The disease burden of axSpA in Singapore is not trivial given that the disease is relatively common. This highlights the need for measures to accommodate patients with axSpA economically in Singapore.
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Affiliation(s)
- Yu Heng Kwan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Shi Yun Kwoh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Jie Kie Phang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | | | - Ka Keat Lim
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Charmaine Tze May Wang
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore
| | - Ying Ying Leung
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Hwee-Ling Koh
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Truls Ostbye
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Julian Thumboo
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Warren Fong
- Department of Rheumatology and Immunology, Singapore General Hospital, Singapore, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Fang ML, Wu CS, Weng LC, Huang HL. Factors associated with depressive symptoms in patients with ankylosing spondylitis in Northern Taiwan. PLoS One 2019; 14:e0224298. [PMID: 31648243 PMCID: PMC6812870 DOI: 10.1371/journal.pone.0224298] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/09/2019] [Indexed: 12/17/2022] Open
Abstract
Patients with ankylosing spondylitis (AS) experience impaired physical function and reduced quality of life, which puts this group at high risk for depression. Identifying factors associated with depressive symptoms could improve outcomes for this at-risk group. However, few studies have examined the relationship between demographic and clinical variables and depressive symptoms in patients with AS. This cross-sectional correlation study recruited patients with AS by convenience sampling from the division of immunology and rheumatology of a medical center in Northern Taiwan. Participants (N = 120) included 91 males and 29 females, age ≥ 20 years. Data were collected from chart reviews, and structural questionnaires, which included demographic information regarding employment status, history of falls, impact of AS on work; clinical information relative to AS was obtained from structural questionnaires: the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and functional index (BASFI), Numerical Rating Scale (NRS), Body Image Scale (BIS), and Beck Depression Inventory-II (BDI-II). Multiple regression analysis identified predictors of depression. The mean BDI-II score was 9.50 ± 8.30; 25% had scores indicating mild to severe depressive symptoms. Mean score on the BIS was 68.17 ± 16.14; 14.2% had fallen within the previous year; and 57.5% reported AS affected their work. Variables associated with depressive symptoms were work affected by AS (β = 0.14, p = .049), occurrence of a fall within the previous year (β = 0.14, p = .032), higher scores on the BASDAI (β = 0.21, p = .032), and lower body image (β = −0.38, p < .001). Clinical professionals should regularly assess patients with AS for depressive symptoms. Health care planning should provide instruction in fall prevention and control of disease activity, and strategies to improve body image, which could improve patients’ self-management capabilities and body image as well as mitigate depressive symptoms.
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Affiliation(s)
- Mei-Ling Fang
- Department of Nursing, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Chien-Sheng Wu
- Division of Allergy, Immunology and Rheumatology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Li-Chueh Weng
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Li Huang
- Department of Long-term Care, College of Health Technology, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
- * E-mail:
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Zhong L, Song H, Wang W, Li J, Ma M. MEFV M694V mutation has a role in susceptibility to ankylosing spondylitis: A meta-analysis. PLoS One 2017; 12:e0182967. [PMID: 28800602 PMCID: PMC5553723 DOI: 10.1371/journal.pone.0182967] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Accepted: 07/27/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE The aim of the current study was to determine the contributions of several common mutations in the Mediterranean fever (MEFV) gene, namely, E148Q, M680I, M694V and V726A, to ankylosing spondylitis (AS) susceptibility. METHODS Two investigators independently searched the literature regarding the association of MEFV with AS in the PubMed, EMBASE, Web of Science, and Scopus databases. They independently selected eligible articles and then extracted data from the included studies. The associations between MEFV mutations and AS risk were assessed with odds ratios (ORs) and 95% confidence intervals (95% CI). Further analyses were conducted with STATA 12.0 software (Stata Corp.; College Station, Texas, USA). RESULTS Four mutations (E148Q, M680I, M694V and V726A) were genotyped in 869 AS cases and 879 controls from the 8 eligible studies. Of the four mutations, M694V (pooled OR: 3.330, 95% CI: 2.129-5.208) was found to be associated with AS through overall analysis. However, the other mutations demonstrated no relation with AS (pooled ORs: 1.295, 1.258, 1.778; 95% CI: 0.886-1.891, 0.688-2.298 and 0.938-3.371). No significant publication bias was discovered in the meta-analysis. CONCLUSIONS The present study indicates that the MEFV M694V mutation may contribute to the pathogenesis of AS. The associations between the other mutations and AS need to be validated with more relevant and well-designed studies.
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Affiliation(s)
- Linqing Zhong
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongmei Song
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Wang
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ji Li
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mingsheng Ma
- Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Rohde G, Berg KH, Prøven A, Haugeberg G. The relationship between demographic- and disease-related variables and health-related quality of life in patients with axial spondyloarthritis. BMC Musculoskelet Disord 2017; 18:328. [PMID: 28764693 PMCID: PMC5540516 DOI: 10.1186/s12891-017-1693-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 07/24/2017] [Indexed: 11/10/2022] Open
Abstract
Background Axial spondyloarthritis (ax-SpA) is a chronic inflammatory disease of the spine causing pain, stiffness, loss in physical function, and fatigue. Therefore, the physical and psychological burden of having this chronic disease can reduce the quality of life. We aimed to explore the relationship between demographic- and disease-related variables and health-related quality of life (HRQoL) in patients with ax-SpA. Methods Demographic- and disease-related, HRQoL-related and treatment data were collected. Disease measures included the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the BAS Functional Index (BASFI), the BAS Global (BAS-G) score, the Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), the Health Assessment Questionnaire (HAQ) and co-morbidity. HRQoL was assessed using the SF-36 and the utility measures SF-6D and 15D. Variables associated with HRQoL were identified in unadjusted and adjusted analyses. Results We examined 380 patients with ax-SpA (67% men) with a mean age of 46 years. Among them, 86% reported exercising >1 h per week. Mean values were as follows: BASDAI, 3.17; MASES, 3.19; BASFI, 2.71; BAS-G. 3.88; and HAQ, 0.56. The percentage of current users of NSAIDs was 44%, and of DMARDs 23%. In multivariate analyses, exercising 1–3 h per week (B = 2.73, p = 0.022) and exercising >3 h per week (B = 2.71, p = 0.020), lower HAQ scores (B = −4.61, p = 0.001), lower BASFI scores (B = −1.05, p = 0.010) and lower BAS-G scores (B = −0.91, p = 0.001) were independently associated with higher SF-36-PCS scores, whereas modest alcohol consumption (B = 4.63, p = 0.018) and a lower BAS-G score (B = −1.73, p < 0.001) were independently associated with higher SF-36-MCS scores. Exercising 1–3 h per week (B = 0.032, p = 0.004) and exercising >3 h per week (B = 0.036, p = 0.001), lower HAQ scores (B = −0.051, p < 0.001), lower BAS-G scores (B = −0.010, p < 0.001) and co-morbidity (B = −0.014, p = 0.004) were independently associated with higher 15D scores. Finally, exercising 1–3 h per week (B = 0.045, p = 0.001) and exercising > 3 h per week (B = 0.053, p < 0.001), lower HAQ scores (B = −0.054, p = 0.001) and lower BAS-G scores (B = −0.020, p < 0.001) were associated with higher SF-6D scores. Conclusions In patients with ax-SpA, a low level of physical activity, impaired physical function and impaired general well-being were independently and consistently associated with a decreased HRQoL across all applied measures.
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Affiliation(s)
- Gudrun Rohde
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, 422, 4604, Kristiansand, Norway. .,Department of Clinical Research, Sorlandet Hospital, Kristiansand, 4604, Norge. .,Marie Curie Palliative Care Research Department and Division of Psychiatry, University College London, London, UK.
| | - Kari Hansen Berg
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, 422, 4604, Kristiansand, Norway
| | - Anne Prøven
- Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway
| | - Glenn Haugeberg
- Department of Clinical Research, Sorlandet Hospital, Kristiansand, 4604, Norge.,Department of Rheumatology, Martina Hansens Hospital, Bærum, Norway.,Department of Neurosciences, Rheumatology Division, INM, Norwegian University of Science and Technology, Trondheim, Norway
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11
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Functional limitation and associated factors in outpatients with ankylosing spondylitis in Southwest China. Clin Rheumatol 2017; 36:871-877. [DOI: 10.1007/s10067-017-3563-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/23/2017] [Accepted: 01/24/2017] [Indexed: 11/29/2022]
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