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Saketkoo LA, Valenzuela A, Kim S, McCann LJ, Lood C, Wahezi DM, Werth VP, Yi B, Alexanderson H, Maillard S, Pilkington C, Fligelstone K, Limbach B, Orandi AB, Regardt M, Russell AM, Davuluri S, deGroot I, Ernste F, Paik JJ, von Muhlen CA, Dimachkie MM, Machado PM, Naddaf E, Shafranski BM, Gupta L, Zulian F, Chung L. Moving forward together: collaborative landscapes of research in idiopathic inflammatory myopathies and calcinosis. Rheumatology (Oxford) 2024; 63:1189-1191. [PMID: 37449887 DOI: 10.1093/rheumatology/kead331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 06/27/2023] [Indexed: 07/18/2023] Open
Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Louisiana State University and Tulane University Medical Schools, New Orleans, LA, USA
| | - Antonia Valenzuela
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Susan Kim
- Department of Pediatrics, Division of Pediatric Rheumatology, University of California, San Francisco, CA, USA
| | - Liza J McCann
- Alder Hey Children's NHS Foundation Trust, Liverpool, UK
| | - Christian Lood
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - Dawn M Wahezi
- Division of Pediatric Rheumatology, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Victoria P Werth
- Department of Dermatology, University of Pennsylvania and Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA
| | - Belina Yi
- Division of Rheumatology, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Helene Alexanderson
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, and Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Susan Maillard
- Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | | | - Kim Fligelstone
- Federation of European Scleroderma Associations (FESCA), Scleroderma & Raynaud's UK (SRUK), European League Against Rheumatism (EULAR), People with Arthritis & Rheumatism Across Europe (PARE), London, UK
| | - Barbara Limbach
- CureJM, Childhood Arthritis and Rheumatism Alliance (CARRA), Wolcottville, IN, USA
| | - Amir B Orandi
- Pediatric and Adolescent Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN, USA
| | - Malin Regardt
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division for Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Russell
- Exeter Respiratory Innovations Center University of Exeter and Royal Devon University Hospitals NHS Trust, Devon, UK
| | - Srijana Davuluri
- Department of Immunology and Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ingrid deGroot
- Spierziekten Nederland (Dutch patient association for NeuroMuscular Diseases), Dutch Myositis Network, TMA Medical Advisory Board, Rotterdam, The Netherlands
| | - Floranne Ernste
- Mayo Clinic, Division of Rheumatology, Department of Internal Medicine, Rochester, MN, USA
| | - Julie J Paik
- Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Mazen M Dimachkie
- Department of Neurology, The University of Kansas Medical Center, Kansas City, KS, USA
| | - Pedro M Machado
- Centre for Rheumatology & Department of Neuromuscular Diseases, Department of Rheumatology & Queen Square Centre for Neuromuscular Diseases, University College London Hospitals NHS Foundation Trust, London, UK
| | - Elie Naddaf
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, Manchester, UK
- Department of Rheumatology, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Francesco Zulian
- Rheumatology Unit, Department of Woman's and Child's Health, University of Padova, Padua, Italy
| | - Lorinda Chung
- Department of Medicine and Dermatology, Division of Immunology & Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA
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Lanis A, Alexanderson H, Ardalan K, Edison S, Graham CD, de Groot I, Gupta L, Kim S, Knight AM, Kobert L, Livermore P, Lood C, Pilkington C, Regardt M, Rubinstein TB, Shenoi S, Turnier L, Voet NBM, Wahezi DM, Saketkoo LA. Mental health in paediatric and adult myositis-related diseases: current state of research, interventions, and future steps from the MIHRA Psychological Impact Scientific Working Group. Clin Exp Rheumatol 2024; 42:413-424. [PMID: 38488093 DOI: 10.55563/clinexprheumatol/cngdfn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 02/02/2024] [Indexed: 03/19/2024]
Abstract
Psychological and emotional well-being are critical aspects of overall health for individuals with chronic rheumatologic conditions. Mental health-related literature, however, predominantly focuses on systemic lupus erythematosus or rheumatoid arthritis, with limited emphasis on idiopathic inflammatory myopathies (IIMs). High proportions of those with juvenile myositis report psychological distress at levels warranting mental health referral. Adults with dermatomyositis diagnosed with depression or anxiety do not receive adequate mental health care. Mental health symptoms in those with IIMs are associated with worse health-related quality of life, medication adherence, and disease outcomes. Despite demonstrated high rates of mental health burden, access to mental health care remains severely lacking.Data related to mental health burden is limited by small sample size, limited generalisability, variable methods of assessment, and inconsistent diagnosis codes to define mental health conditions. Additional research is needed to validate current screening tools in myositis populations. Other relevant measurable factors include disease severity, non-health- and health-related trauma exposure, loneliness, isolation, loss of control, sleep difficulties, fatigue, pain, self-esteem, body image, sexual health, and health inequities. Studiesare needed investigating the efficacy of therapeutic and pharmacologic interventions among patients with myositis who experience depression and anxiety. Currently, knowledge and resources are limited around mental health burden and potential intervention for those living with IIMs. The Myositis International Health & Research Collaborative Alliance (MIHRA) Psychological Impact Scientific Working Group offers a preliminary road map to characterise and prioritise the work ahead to understand baseline mental health burden and compare avenues for intervention.
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Affiliation(s)
- Aviya Lanis
- Seattle Children's Hospital and Research Center, University of Washington, Seattle, WA, USA.
| | - Helene Alexanderson
- Theme Women's Health and Health Professionals, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, and Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Kaveh Ardalan
- Department of Paediatrics, Division of Paediatric Rheumatology, Duke University School of Medicine, Durham, NC, USA
| | | | - Christopher D Graham
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Ingrid de Groot
- Dutch Myositis Group at Spierziekten Nederland (Dutch patient association for NMD), Baarn, The Netherlands
| | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, and Division of Musculoskeletal and Dermatological Sciences, Centre for Musculoskeletal Research, School of Biological Sciences, The University of Manchester, UK
| | - Susan Kim
- Department of Paediatrics, Division of Paediatric Rheumatology, Benioff Children's Hospital, University of California, San Francisco, CA, USA
| | - Andrea M Knight
- Hospital for Sick Children, Division of Rheumatology, Toronto, and SickKids Research Institute, Neurosciences and Mental Health Program; University of Toronto Temerty Faculty of Medicine, Toronto, Canada
| | | | | | - Christian Lood
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | | | - Malin Regardt
- Theme Women's Health and Health Professionals, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, and Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Tamar B Rubinstein
- Children's Hospital at Montefiore, Division of Paediatric Rheumatology, Bronx, NY, and Albert Einstein College of Medicine, Department of Paediatrics, Bronx, NY, USA
| | - Susan Shenoi
- Seattle Children's Hospital and Research Center, University of Washington, Seattle, WA, USA
| | | | - Nicole B M Voet
- Rehabilitation Center Klimmendaal Arnhem, and Radboud University Medical Center Nijmegen, The Netherlands
| | - Dawn M Wahezi
- Children's Hospital at Montefiore, Division of Paediatric Rheumatology, Bronx, NY, and Albert Einstein College of Medicine, Department of Paediatrics, Bronx, NY, USA
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans; University Medical Center, Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, and Tulane University School of Medicine, Undergraduate Honors Department, New Orleans, LA, USA
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Saygin D, DiRenzo D, Raaphorst J, de Groot I, Bingham CO, Lundberg IE, Regardt M, Sarver C, de Visser M, Maxwell LJ, Beaton D, Kim JY, Needham M, Alexanderson H, Christopher-Stine L, Mecoli CA, Park JK. Responsiveness and meaningful thresholds of PROMIS pain interference, fatigue, and physical function forms in adults with idiopathic inflammatory myopathies: Report from the OMERACT Myositis Working Group. Semin Arthritis Rheum 2024; 64:152339. [PMID: 38141522 DOI: 10.1016/j.semarthrit.2023.152339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 11/18/2023] [Accepted: 11/28/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND A series of qualitative studies conducted by the OMERACT Myositis Working Group identified pain interference, fatigue, and physical function as highly important life impact domains for adults with idiopathic inflammatory myositis (IIM). In this study, our goal was to assess the responsiveness and minimal important difference of PROMIS pain interference (6a), fatigue (7a), and physical function (8b). METHODS Adults with IIM from USA, Netherlands, Korea, Sweden, and Australia with two "clinical" visits were enrolled in this prospective study. Anchor questions on a Likert scale were collected at baseline, and manual muscle testing (MMT), physician and patient reported global disease activity, and PROMIS instruments were collected at both visits. Responsiveness was assessed with i) ANOVA, ii) paired t-test, effect size and standardized response mean, and iii) Pearson correlation. Minimal important difference (MID), minimal important change (MIC) and minimal detectable change (MDC) values were calculated. RESULTS 114 patients with IIM (median age 60, 60 % female) completed both visits. Changes in PROMIS instruments were significantly different among anchor categories. Patients who reported improvement had a significant improvement in their PROMIS scores with at least medium effect size, while patients who reported worsening and stability did not show a significant change with weak effect size. PROMIS instruments had weak to moderate correlations with MMT, patient and physician global disease activity. MID was approximately 2-3 points for Pain Interference and 3-4 points for Fatigue and Physical Function forms based on the method used. MIC was approximately 4-5 for improvement of all the instruments, while MDC was 1.7-2 points for Pain Interference and Physical Function and 3.2-3.9 for Fatigue. CONCLUSION This study provides evidence towards the responsiveness of the PROMIS instruments in a large international prospective cohort of adults with IIM supporting their use as PROMs in adult myositis.
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Affiliation(s)
- D Saygin
- Division of Rheumatology, Department of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - D DiRenzo
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, Philadelphia, USA
| | - J Raaphorst
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | | | - C O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - I E Lundberg
- Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Karolinska University, Stockholm, Sweden
| | - M Regardt
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - M de Visser
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - L J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - D Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - J Y Kim
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - M Needham
- Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - H Alexanderson
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - L Christopher-Stine
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - C A Mecoli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - J K Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea.
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Saketkoo LA, Paik JJ, Alexanderson H, Dimachkie MM, Ernste FC, Naddaf E, Shafranski B, Gupta L, Mecoli CA, Saygin D, Albayda J, Basharat P, Day JA, Valenzuela A, Bromley R, de Groot I, Edison SE, Lanis A, Lood C, Regardt M, Yi BY, Benitez AC, Chinoy H, Christopher-Stine L, Isenberg DA, Lang B, Oddis CV, van Royen A, Vencovsky J, Werth VP, Machado PM. Collaborative research in myositis-related disorders: MIHRA, a global shared community model. Clin Exp Rheumatol 2024; 42:207-212. [PMID: 38436382 DOI: 10.55563/clinexprheumatol/hc1lsf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 02/05/2024] [Indexed: 03/05/2024]
Abstract
Myositis International Health and Research Collaborative Alliance (MIHRA) is a newly formed purpose-built non-profit charitable research organization dedicated to accelerating international clinical trial readiness, global professional and lay education, career development and rare disease advocacy in IIM-related disorders. In its long form, the name expresses the community's scope of engagement and intent. In its abbreviation, MIHRA, conveys linguistic roots across many languages, that reflects the IIM community's spirit with meanings such as kindness, community, goodness, and peace. MIHRA unites the global multi-disciplinary community of adult and pediatric healthcare professionals, researchers, patient advisors and networks focused on conducting research in and providing care for pediatric and adult IIM-related disorders to ultimately find a cure. MIHRA serves as a resourced platform for collaborative efforts in investigator-initiated projects, consensus guidelines for IIM assessment and treatment, and IIM-specific career development through connecting research networks.MIHRA's infrastructure, mission, programming and operations are designed to address challenges unique to rare disease communities and aspires to contribute toward transformative models of rare disease research such as global expansion and inclusivity, utilization of community resources, streamlining ethics and data-sharing policies to facilitate collaborative research. Herein, summarises MIHRA operational cores, missions, vision, programming and provision of community resources to sustain, accelerate and grow global collaborative research in myositis-related disorders.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, Louisiana State University and Tulane University Schools of Medicine, New Orleans, LA, USA.
| | - Julie J Paik
- Johns Hopkins Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Helene Alexanderson
- Karolinska Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, and Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | | | | | | | | | - Latika Gupta
- Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, and Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, UK
| | - Christopher A Mecoli
- Johns Hopkins Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Didem Saygin
- Division of Rheumatology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jemima Albayda
- Johns Hopkins Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Jessica A Day
- Walter and Eliza Hall Institute of Medical Research, Melbourne, Australia
| | - Antonia Valenzuela
- Department of Rheumatology and Clinical Immunology, Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | - Ingrid de Groot
- The Myositis Association, Columbia, MD, USA, and Spierziekten Nederland (Dutch patient association for NeuroMuscular Diseases), Dutch Myositis Network, TMA Medical Advisory Board, The Netherlands
| | | | - Aviya Lanis
- Seattle Children's Hospital, Seattle, WA, USA
| | - Christian Lood
- Division of Rheumatology, University of Washington, Seattle, WA, USA
| | - Malin Regardt
- Karolinska Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, and Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Belina Y Yi
- Johns Hopkins Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Alejandro C Benitez
- Rheumatology Department at the National Hospital Alejandro Posadas, University of Buenos Aires, Argentina
| | - Hector Chinoy
- Division of Musculoskeletal and Dermatological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, and Department of Rheumatology, Salford Royal Hospital, Northern Care Alliance NHS Foundation Trust, Manchester Academic Health Science Centre, Salford, UK
| | - Lisa Christopher-Stine
- Johns Hopkins Division of Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David A Isenberg
- Centre for Rheumatology, Division of Medicine, University College London, UK
| | - Bianca Lang
- Department of Paediatrics and Medicine, Dalhousie University and IWK Health, Halifax, NS, Canada
| | - Chester V Oddis
- Division of Rheumatology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Victoria P Werth
- Department of Dermatology, University of Pennsylvania and Corporal Michael J. Crescenz VAMC, Philadelphia, PA, USA
| | - Pedro M Machado
- Department of Neuromuscular Diseases and Centre for Rheumatology, University College London; and Department of Rheumatology and Queen Square Centre for Neuromuscular Diseases, University College London Hospitals NHS Foundation Trust, London, UK
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Kembe J, Regardt M. Experiences of participation in activities among girls with juvenile idiopathic arthritis: A qualitative study. J Child Health Care 2023; 27:599-611. [PMID: 35403449 PMCID: PMC10676619 DOI: 10.1177/13674935221083167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to describe how girls with juvenile idiopathic arthritis (JIA) experience participation in activities in relation to their disease. Semi-structured interviews of eight girls with JIA in ages 12-15 were recorded and transcribed as a whole. Data have been analysed with qualitative content analysis. Participation was influenced by disease symptoms, which could result in absence and exclusion from participation in activities. The experience of participation was affected by the participant's choice of using strategies and making adjustments during activities. Social environment could both increase and decrease participation through treatment and type of knowledge about the disease. Also the physical environment could affect participation due to the climate or road and ground conditions. We could conclude that the experience of participation among girls with JIA was affected by disease symptoms, perceptions of selves, disease and the use of strategies, and also the social and physical environment. This indicates the need to address participation in clinical practice and the importance to include different health professionals, teachers and other personnel involved in the child's schooling.
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Affiliation(s)
- Johanna Kembe
- Women´s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Malin Regardt
- Women´s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, care sciences and society Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
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Hua N, Gomez A, Lindblom J, Emamikia S, Enman Y, Grannas D, Heintz E, Regardt M, Parodis I. Sensitivity analysis of EQ-5D-3L index scores in terms of discriminative and known-groups validity in SLE: introducing Adequate Health State. Rheumatology (Oxford) 2023; 62:3916-3923. [PMID: 36946293 PMCID: PMC10691928 DOI: 10.1093/rheumatology/kead140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/28/2023] [Accepted: 03/18/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES To investigate the ability of different EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) index scores to discriminate between verum drug and placebo (discriminant validity) as well as between responders and non-responders (known-groups validity) in the SLE patient population of two phase III clinical trials of belimumab. METHODS Data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials (N = 1684), which both showed superiority of belimumab to placebo, were utilized. Responders were defined as SLE Responder Index 4 (SRI-4) achievers at week 52. The Pearson's χ2 and Mann-Whitney U tests were used for comparisons, and logistic regression analysis was used for adjustments for confounders and assessment of independence. RESULTS While full health state (FHS; EQ-5D index score 1) showed the best ability to discriminate between belimumab and placebo [adjusted odds ratio (OR) 1.47; 95% CI 1.11, 1.96; P = 0.008] and between SRI-4 responders and non-responders (adjusted OR 3.47; 95% CI 1.29, 10.98; P = 0.020), the discriminative ability of EQ-5D index scores 0.800 or more reached statistical significance for both discriminant validity (adjusted OR 1.29; 95% CI 1.02, 1.63; P = 0.036) and known-groups validity (adjusted OR 3.08; 95% CI 1.16, 9.69; P = 0.034). CONCLUSION Overall, higher EQ-5D index scores were associated with increasing ability to discriminate between belimumab and placebo, and between responders and non-responders. EQ-5D index scores less stringent than FHS may be clinically relevant health-related quality of life goals of treatment in patients with SLE, introducing the concept of EQ-5D adequate health state when FHS is not achievable.
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Affiliation(s)
- Nicole Hua
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- The Swedish Rheumatism Association, Stockholm, Sweden
| | - David Grannas
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Emelie Heintz
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
- Women’s Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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7
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Borg A, Lindblom J, Gomez A, Soltani A, Enman Y, Heintz E, Regardt M, Grannas D, Emamikia S, Parodis I. Obesity is associated with pain and impaired mobility despite therapy in systemic lupus erythematosus. Front Med (Lausanne) 2023; 10:1247354. [PMID: 37692782 PMCID: PMC10484101 DOI: 10.3389/fmed.2023.1247354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 08/15/2023] [Indexed: 09/12/2023] Open
Abstract
Objective To investigate whether abnormal BMI is associated with health-related quality of life (HRQoL) impairments, defined as patient-reported problems within the different dimensions of the three-level EQ-5D (EQ-5D-3L), before and after treatment for active systemic lupus erythematosus (SLE). Patients and methods We conducted a post-hoc analysis of data from two phase III clinical trials of belimumab in SLE, i.e., BLISS-52 (n = 865) and BLISS-76 (n = 819). Underweight was defined as BMI <18.5 kg/m2, normal weight as BMI ≥18.5 but <25 kg/m2, pre-obesity as BMI ≥25 but <30 kg/m2, and obesity as BMI ≥30 kg/m2. We investigated associations between BMI groups and problems (level 2 or 3) within each one of the five EQ-5D dimensions before treatment initiation and at week 52, using logistic regression analysis adjusting for age, ethnicity, disease activity, and glucocorticoid dose, and for the post-treatment analysis also for belimumab treatment and baseline EQ-5D-3L responses. Results Of 1,684 patients included, 73 (4%) were classified as underweight, 850 (50%) as normal weight, 438 (26%) as pre-obese, and 323 (19%) as obese. At baseline, obesity was associated with mild to severe problems in all EQ-5D dimensions (p < 0.05 for all), yielding the strongest association with problems in mobility (adjusted odds ratio, aOR: 2.1; 95% confidence interval, CI: 1.6-2.8; p < 0.001). Pre-obesity was also associated with problems in mobility (aOR: 1.4; 95% CI: 1.1-1.8; p = 0.005). Post-intervention, obesity was associated with problems in mobility and pain/discomfort, and pre-obesity with problems in mobility and self-care (p < 0.05 for all). Conclusion Our study adds to the evidence that high BMI negatively affects SLE patients' HRQoL, with obesity being associated with pain and impaired mobility despite therapy.
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Affiliation(s)
- Alexander Borg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ameneh Soltani
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Emelie Heintz
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - David Grannas
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
- Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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8
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DiRenzo D, Saygin D, de Groot I, Bingham Iii CO, Lundberg IE, Needham M, Park JK, Regardt M, Sarver C, Song YW, Maxwell L, Beaton D, de Visser M, Christopher-Stine L, Mecoli CA, Alexanderson H. Reliability and validity of PROMIS physical function, pain interference, and fatigue as patient reported outcome measures in adult idiopathic inflammatory myopathies: International study from the OMERACT myositis working group. Semin Arthritis Rheum 2023; 58:152111. [PMID: 36410180 PMCID: PMC10354786 DOI: 10.1016/j.semarthrit.2022.152111] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 08/01/2022] [Accepted: 08/05/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Pain interference, fatigue, and impaired physical function are common features of idiopathic inflammatory myopathies (IIM). The objective of this study was to evaluate the construct validity and test-retest reliability of the Patient Reported Outcome Information System (PROMIS) Pain Interference 6av1.0, Fatigue 7av1.0, and Physical Function 8bv2.0 instruments. METHODS Patient-Reported Outcome Measures (PROMs) were deployed to adult IIM patients from OMERACT Myositis Working Group (MWG) international clinic sites via two online surveys (2019, 2021). Internal consistency of each PROM was analyzed by Cronbach's α. Construct validity was determined by a priori hypotheses generated by the MWG with >75% agreement for each hypothesis and calculated with Pearson correlations. Test-retest reliability was assessed using intraclass correlation coefficient with PROMIS instruments administered at time zero and 7 days. RESULTS Surveys were sent to 368 participants in total; participants who completed each questionnaire varied (n=65 to 263). For construct validity, 10 out of 13 a priori hypotheses were met supporting construct validity of PROMIS instruments (Pain Interference 3/4, fatigue 4/4, and Physical Function 3/5). Test-retest reliability was strong for all PROMIS instruments. All PROMIS instruments demonstrated excellent internal consistency. None of the measures demonstrated any ceiling or floor effects except for a ceiling effect in the Pain Interference instrument. CONCLUSIONS This study presents test-retest reliability and construct validity evidence supporting PROMIS Pain Interference (6a v1.0), Fatigue (7a v1.0), and Physical Function (8b v2.0) using a large international cohort of patients with IIM. Internal consistency of these instruments was excellent. A ceiling effect was noted in the Pain Interference instrument.
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Affiliation(s)
- Dana DiRenzo
- Division of Rheumatology, Department of Medicine, University of Pennsylvania, USA
| | - Didem Saygin
- Division of Rheumatology, Department of Medicine, University of Chicago, USA
| | | | | | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska Institutet, Karolinska University, Solna, Stockholm, Sweden
| | - Merrilee Needham
- Dept Neurology, Fiona Stanley Hospital, IIID Murdoch University and University of Notre Dame, Perth, Australia
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital and College of Medicine, Seoul, Korea
| | - Malin Regardt
- Occupational Therapist, Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | | | - Yeong Wook Song
- Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University
| | - Lara Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Dorcas Beaton
- Institute for Work & Health and Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, the Netherlands
| | | | - Christopher A Mecoli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, USA.
| | - Helene Alexanderson
- Physiotherapist, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital and Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
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9
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Lindblom J, Zetterberg S, Emamikia S, Borg A, von Perner G, Enman Y, Heintz E, Regardt M, Grannas D, Gomez A, Parodis I. EQ-5D full health state after therapy heralds reduced hazard to accrue subsequent organ damage in systemic lupus erythematosus. Front Med (Lausanne) 2022; 9:1092325. [PMID: 36606059 PMCID: PMC9807754 DOI: 10.3389/fmed.2022.1092325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
Objectives To investigate whether self-reported EQ-5D full health state (FHS) after therapeutic intervention for active systemic lupus erythematosus (SLE) is associated with a reduced risk to accrue organ damage. In a separate analysis, we sought to investigate associations between experience of "no problems" in each one of the five dimensions of EQ-5D and the risk to accrue damage. Methods Data from the open-label extension periods of the BLISS-52 and BLISS-76 trials of belimumab in SLE (NCT00724867; NCT00712933) were used (N = 973). FHS was defined as an experience of "no problems" in all five EQ-5D dimensions. Organ damage was assessed annually using the Systemic Lupus International Collaborating Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (SDI). Associations between the three-level version of the EQ-5D (EQ-5D-3L) responses at open-label baseline and the first documented increase in organ damage were investigated using Cox regression accounting for age, sex, ancestry, SDI at baseline, and background therapy, and associations with SDI items were investigated using phi (φ) correlation analyses. Results A total of 147 patients (15.1%) accrued organ damage during follow-up, with the first increase in their SDI score occurring after a mean time of 29.1 ± 19.6 months. Lower proportions of FHS respondents accrued damage over a course of up to 7.9 years of open-label follow-up compared with no FHS respondents (p = 0.004; derived from the logrank test). FHS was associated with a reduced hazard to accrue subsequent organ damage (HR: 0.60; 95% CI: 0.38-0.96; p = 0.033) after adjustments, as was experience of "no problems" in mobility (HR: 0.61; 95% CI: 0.43-0.87; p = 0.006). "No problems" in mobility was negatively correlated with musculoskeletal damage accrual (φ = -0.08; p = 0.008) and associated with a lower hazard to accrue musculoskeletal damage in Cox regression analysis (HR: 0.38; 95% CI: 0.19-0.76; p = 0.006). Conclusion Experience of EQ-5D-3L FHS and "no problems" in mobility after therapeutic intervention heralded reduced hazard to accrue subsequent organ damage, especially musculoskeletal damage, suggesting that optimisation of these health-related quality of life aspects constitutes a clinically relevant treatment target in patients with SLE, along with clinical and laboratory parameters.
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Affiliation(s)
- Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Sture Zetterberg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Alexander Borg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | | | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Emelie Heintz
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden,Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - David Grannas
- Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden,Department of Rheumatology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden,*Correspondence: Ioannis Parodis,
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10
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Saketkoo LA, Escorpizo R, Varga J, Keen KJ, Fligelstone K, Birring SS, Alexanderson H, Pettersson H, Chaudhry HA, Poole JL, Regardt M, LeSage D, Sarver C, Lanario J, Renzoni E, Scholand MB, Lammi MR, Kowal-Bielecka O, Distler O, Frech T, Shapiro L, Varju C, Volkmann ER, Bernstein EJ, Drent M, Obi ON, Patterson KC, Russell AM. World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) Core Set Development for Interstitial Lung Disease. Front Pharmacol 2022; 13:979788. [PMID: 36313333 PMCID: PMC9615472 DOI: 10.3389/fphar.2022.979788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 07/13/2022] [Indexed: 12/13/2022] Open
Abstract
Background: The World Health Organization (WHO) introduced the International Classification of Functioning, Disability, and Health (ICF) as a scientific method of disability data collection comprised of >1,200 categories describing the spectrum of impairment types (functional, symptoms-based and anatomical) under the bio-psycho-social model with consideration of environmental and personal factors (pf). ICF Core Sets and ICF Checklists are streamlined disease-specific resources for clinical use, service provision, and for use in health economics and health policy. ICF can disclose strengths and weaknesses across multiple patient-reported outcome measures (PROMs) and help consolidate best-fitting question-items from multiple PROMs. Interstitial lung diseases (ILDs), are generally progressive, with restrictive physiology sometimes occurring in the context of multi-organ autoimmunity/inflammatory conditions such as connective tissue diseases (CTDs). In spite of significant associated morbidity and potential disability, ILD has yet to be linked to the ICF. Methods: Each instrument and their question-items within the consensus-recommended core sets for clinical trials in ILD were deconstructed to single concept units, and then linked per updated ICF linkage rules. Inter-linker agreement was established. Three additional subsequently validated measures were also included. Results: One-hundred-eleven ICF categories were identified for ten PROMs and three traditional objective measures that were amenable to ICF linkage. The proportion of agreement ranged from 0.79 (95% CI: 0.62, 0.91) to 0.93 (0.76, 0.99) with the overall proportion of inter-linker agreement being very high 0.86 (0.82, 0.89) for the initial instruments, with 94-100% for the three additional PROMs. Thirty-four new 'Personal Factors' emerged to capture disease-specific qualities not elsewhere described in ICF, e.g. 'pf_embarrassed by cough' or 'pf_panic/afraid when can't get a breath'. Conclusion: This first known effort in ICF linkage of ILD has provided important revelations on the current utility of the ICF in lung disease. Results have indicated areas for meaningful assessment of ICF descriptors for lung impairment. The mapping across PROMs provides insight into possibilities of developing more streamline and precise instrumentation. Finally, familiarity with the ICF in ILD may enable clinicians to experience a smoother transition with the imminent harmonization of ICD and ICF, ICD-11.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, United States
- University Medical Center—Comprehensive Pulmonary Hypertension Center & Interstitial Lung Disease Clinic Programs, New Orleans, LA, United States
- Tulane University School of Medicine, New Orleans, LA, United States
- Louisiana State University Health Sciences Center, Division of Pulmonary Medicine—New Orleans, New Orleans, LA, United States
- *Correspondence: Lesley Ann Saketkoo, ; Anne-Marie Russell,
| | - Reuben Escorpizo
- Department of Rehabilitation and Movement Science, The University of Vermont, Burlington, VT, United States
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Janos Varga
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Kevin John Keen
- Department of Mathematics and Statistics and Health Research Institute, University of Northern British Columbia, Prince George, BC, Canada
- Department of Medicine, University of British Columbia & Centre for Heart Lung Innovation, Providence Research, Vancouver, BC, Canada
| | - Kim Fligelstone
- Patient Research Partner Scleroderma & Raynaud Society, UK (SRUK) and Federation of European Scleroderma Associations, London, United Kingdom
- Royal Free Hospital Scleroderma Unit, London, United Kingdom
| | - Surinder S. Birring
- Division of Asthma, Allergy and Lung Biology, King’s College London, London, United Kingdom
| | - Helene Alexanderson
- Women’s Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicin, Division of Rheumatology, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Pettersson
- Women’s Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicin, Division of Rheumatology, Karolinska Institutet, Stockholm, Sweden
| | - Humza Ahmad Chaudhry
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, United States
- University Medical Center—Comprehensive Pulmonary Hypertension Center & Interstitial Lung Disease Clinic Programs, New Orleans, LA, United States
- Tulane University School of Medicine, New Orleans, LA, United States
| | - Janet L. Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, United States
| | - Malin Regardt
- Women’s Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Medicin, Division of Rheumatology, Karolinska Institutet, Stockholm, Sweden
| | - Daphne LeSage
- Patient Research Partner, New Orleans, LA, United States
| | | | - Joseph Lanario
- Research Fellow in Respiratory Health—Exeter Respiratory Institute Royal Devon University Hospitals NHS Foundation Trust, Exeter, United Kingdom
| | - Elisabetta Renzoni
- Royal Brompton Hospital, National Heart and Lung Institute, London, United Kingdom
| | - Mary Beth Scholand
- Pulmonary Medicine, University of Utah, Salt Lake City, UT, United States
| | - Matthew R. Lammi
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, LA, United States
- University Medical Center—Comprehensive Pulmonary Hypertension Center & Interstitial Lung Disease Clinic Programs, New Orleans, LA, United States
- Louisiana State University Health Sciences Center, Division of Pulmonary Medicine—New Orleans, New Orleans, LA, United States
| | | | - Oliver Distler
- Division of Rheumatology, University Hospital Zurich, Zurich, Switzerland
| | - Tracy Frech
- Division of Rheumatology Vanderbilt University School of Medicine, Nashville, TN, United States
- Pulmonary Medicine, University of Utah, Salt Lake City, UT, United States
| | - Lee Shapiro
- Division of Rheumatology, Albany Medical Center, Albany, NY, United States
- Steffens Scleroderma Foundation, Albany, NY, United States
| | - Cecilia Varju
- Department of Rheumatology and Immunology, Medical School, University of Pécs, Pecs, Hungary
| | - Elizabeth R. Volkmann
- Department of Medicine, David Geffen School of Medicine, UCLA Scleroderma Program and UCLA CTD-ILD Program, Division of Rheumatology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Elana J. Bernstein
- Department of Medicine, Columbia University/New York-Presbyterian Scleroderma Program, Division of Rheumatology, Columbia University College of Physician2s and Surgeons, New York, NY, United States
| | - Marjolein Drent
- Department of Pulmonology, Interstitial Lung Diseases (ILD) Center of Excellence, St. Antonius Hospital, Nieuwegein, Netherlands
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Nieuwegein, Netherlands
| | - Ogugua Ndili Obi
- Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Brody School of Medicine, East Carolina University, Greenville, NC, United States
| | - Karen C. Patterson
- Department of Clinical & Experimental Medicine, Brighton & Sussex Medical School, Falmer, United Kingdom
- Division Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Anne-Marie Russell
- Respiratory Institute to Exeter Respiratory Innovation Center, University of Exeter, Exeter, United Kingdom
- Respiratory Medicine, Royal Devon University Healthcare NHS Foundation Trust, London, United Kingdom
- *Correspondence: Lesley Ann Saketkoo, ; Anne-Marie Russell,
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11
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Björk M, Dragioti E, Alexandersson H, Esbensen BA, Boström C, Friden C, Hjalmarsson S, Hörnberg K, Kjeken I, Regardt M, Sundelin G, Sverker A, Welin E, Brodin N. Inflammatory Arthritis and the Effect of Physical Activity on Quality of Life and Self-reported Function: A Systematic Review and Meta-analysis - The ENHANCE Study. Arthritis Care Res (Hoboken) 2021; 74:31-43. [PMID: 34632707 DOI: 10.1002/acr.24805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 10/04/2021] [Accepted: 10/07/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Although physical activity (PA) is an evidence-based intervention that reduces disease-related symptoms and comorbidity in rheumatoid arthritis (RA), PA's effect on self-reported function and Quality of Life (QoL) has not been analyzed. This study synthesizes the evidence for the effectiveness of PA on QoL and self-reported function in adults with RA, spondyloarthritis (SpA), and psoriatic arthritis (PsA). METHODS The databases PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify relevant randomized controlled trials (RCTs). Screening, risk of bias assessment (using RoB 2.0 tool), and data extraction were independently performed by two or more of the authors. The meta-analyses were conducted with a random-effects model. RESULTS The systematic review included 55 RCTs and the meta-analysis included 37 RCTs. In 55 studies included, 76% investigated RA, 20% investigated SpA, and 4% investigated PsA. In RA effects were found on QoL and function compared to inactive controls, effects not sustained in comparison to active controls. In SpA the effects of PA on QoL were in favor of the control group. Effects on function were found compared to inactive controls and sustained in fatigue and pain when compared to active controls. In PsA no effects on QoL were found but on function compared to inactive controls. The effect size was below 0.30 in the majority of the comparisons. CONCLUSION PA may improve QoL and self-reported function in RA, SpA, and PsA. However, larger trials are needed, especially in SpA and PsA.
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Affiliation(s)
- Mathilda Björk
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Unit of Occupational Therapy, Linköping University, Norrköping, Sweden
| | - Elena Dragioti
- Pain and Rehabilitation Centre, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Helene Alexandersson
- Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, SE-171 76 Stockholm, and Division of Rheumatology, Department of Medicine, Solna, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Bente Appel Esbensen
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Centre for Head and Orthopaedics, Rigshospitalet, Denmark and Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Carina Boström
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, 14183 Huddinge, Sweden and affiliated to Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physical Therapy, Karolinska University Hospital, Stockholm, Sweden
| | - Cecilia Friden
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, 14183, Huddinge, Sweden
| | | | - Kristina Hörnberg
- Department of Public Health and Clinical Medicine/Rheumatology, Umeå University, Umeå, Sweden
| | - Ingvild Kjeken
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, PO Box 23, Vinderen, N-0319, Oslo, Norway
| | - Malin Regardt
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm Sweden, and Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet Stockholm, Sweden
| | - Gunnevi Sundelin
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Annette Sverker
- Department of Activity and Health and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Elisabet Welin
- Örebro University, School of Health Sciences, Örebro, Sweden
| | - Nina Brodin
- Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, 23100, S-141 83, Huddinge, Sweden and Danderyd Hospital Corp., Department of Orthopaedics, Division of Physiotherapy, 18288, Stockholm, Sweden
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12
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Lindblom J, Gomez A, Borg A, Emamikia S, Ladakis D, Matilla J, Pehr M, Cobar F, Enman Y, Heintz E, Regardt M, Parodis I. EQ-5D-3L full health state discriminates between drug and placebo in clinical trials of systemic lupus erythematosus. Rheumatology (Oxford) 2021; 60:4703-4716. [PMID: 33502473 PMCID: PMC8487305 DOI: 10.1093/rheumatology/keab080] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 01/17/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES The objectives of this study were to investigate the discriminative ability of EQ-5D-3L full health state (FHS) in clinical trials of SLE, and to identify factors associated with FHS after treatment. METHODS Data from the BLISS-52 (NCT00424476) and BLISS-76 (NCT00410384) trials of belimumab (N = 1684) were utilized. FHS was defined as a response of no problems in all five EQ-5D-3L dimensions, yielding an index score of 1. The Pearson's χ2 or Fisher's exact test was employed for comparisons, and logistic regression for adjustments and assessment of independence. RESULTS We demonstrated higher EQ-5D-3L FHS frequencies among patients given standard therapy (ST) plus the licensed belimumab dose vs ST alone (26.1% vs 19.4%; P = 0.001; week 52), and within SRI-4 responders vs non-responders (27.0% vs 19.8%; P < 0.001; week 52) from weeks 36 to 52. In multivariable regression analysis, SLEDAI-2K (OR: 0.90; 95% CI: 0.87, 0.94; P < 0.001) and SLICC/ACR Damage Index (OR: 0.79; 95% CI: 0.69, 0.91; P = 0.001) scores were independently associated with lower FHS frequencies at week 52, while adding monthly infusions of belimumab 10 mg/kg to ST favoured FHS perception (OR: 1.60; 95% CI: 1.15, 2.24; P = 0.006). Add-on belimumab 10 mg/kg yielded higher FHS frequencies in antimalarial users vs non-users (29.9% vs 20.1%; P = 0.011), and in anti-dsDNA- and anti-Sm- positive vs negative patients (31.4% vs 13.4%; P < 0.001 and 33.0% vs 22.6%; P = 0.010, respectively), whereas no significant differences were observed in patients given ST alone. CONCLUSION EQ-5D-3L FHS distinguished belimumab from placebo and responders from non-responders, and exhibited known-group validity in subgroup analysis. FHS may prove a useful patient-reported outcome in SLE studies.
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Affiliation(s)
- Julius Lindblom
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Alvaro Gomez
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Alexander Borg
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Sharzad Emamikia
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Dimitris Ladakis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Joaquin Matilla
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Martin Pehr
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Flordelyn Cobar
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Yvonne Enman
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
| | - Emelie Heintz
- Department of Learning, Informatics, Management and Ethics (LIME)
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet
- Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Ioannis Parodis
- Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet
- Department of Gastroenterology, Dermatology and Rheumatology, Karolinska University Hospital
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13
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Pettersson H, Alexanderson H, Poole JL, Varga J, Regardt M, Russell AM, Salam Y, Jensen K, Mansour J, Frech T, Feghali-Bostwick C, Varjú C, Baldwin N, Heenan M, Fligelstone K, Holmner M, Lammi MR, Scholand MB, Shapiro L, Volkmann ER, Saketkoo LA. Exercise as a multi-modal disease-modifying medicine in systemic sclerosis: An introduction by The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis (G-FoRSS). Best Pract Res Clin Rheumatol 2021; 35:101695. [PMID: 34217607 PMCID: PMC8478716 DOI: 10.1016/j.berh.2021.101695] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Systemic sclerosis (SSc) is a heterogeneous multisystem autoimmune disease whereby its main pathological drivers of disability and damage are vascular injury, inflammatory cell infiltration, and fibrosis. These mechanisms result in diffuse and diverse impairments arising from ischemic circulatory dysfunction leading to painful skin ulceration and calcinosis, neurovascular aberrations hindering gastrointestinal (GI) motility, progressive painful, incapacitating or immobilizing effects of inflammatory and fibrotic effects on the lungs, skin, articular and periarticular structures, and muscle. SSc-related impairments impede routine activities of daily living (ADLs) and disrupt three critical life areas: work, family, social/leisure, and also impact on psychological well-being. Physical activity and exercise are globally recommended; however, for connective tissue diseases, this guidance carries greater impact on inflammatory disease manifestations, recovery, and cardiovascular health. Exercise, through myogenic and vascular phenomena, naturally targets key pathogenic drivers by downregulating multiple inflammatory and fibrotic pathways in serum and tissue, while increasing circulation and vascular repair. G-FoRSS, The Global Fellowship on Rehabilitation and Exercise in Systemic Sclerosis recognizes the scientific basis of and advocates for education and research of exercise as a systemic and targeted SSc disease-modifying treatment. An overview of biophysiological mechanisms of physical activity and exercise are herein imparted for patients, clinicians, and researchers, and applied to SSc disease mechanisms, manifestations, and impairment. A preliminary guidance on exercise in SSc, a research agenda, and the current state of research and outcome measures are set forth.
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Affiliation(s)
- Henrik Pettersson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Helene Alexanderson
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Division of Rheumatology, Department of Medicin, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, USA
| | - Janos Varga
- Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Malin Regardt
- Women's Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden; Department of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Anne-Marie Russell
- University of Exeter, College of Medicine and Health, Exeter, UK; National Institute of Health Research, Senior Nurse Research Leader, London, UK
| | - Yasser Salam
- Department of Physical Therapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Kelly Jensen
- Oregon Health and Science University, Portland, OR, USA; New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Jennifer Mansour
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA
| | - Tracy Frech
- Vanderbilt University, Division of Rheumatology, Nashville, TN, USA
| | | | - Cecília Varjú
- Department of Rheumatology and Immunology, University of Pécs Clinical Center, Pecs, Hungary
| | | | - Matty Heenan
- Scleroderma Foundation/Pulmonary Hypertension Association, Tucson, AZ, USA
| | - Kim Fligelstone
- Scleroderma & Raynaud Society UK (SRUK), London, UK; Royal Free Hospital, London, UK
| | - Monica Holmner
- The Swedish Rheumatism Association National Association for Systemic Sclerosis, Sweden
| | - Matthew R Lammi
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA
| | - Mary Beth Scholand
- University of Utah, Division of Pulmonary Medicine, Pulmonary Fibrosis Center, Salt Lake City, UT, USA
| | - Lee Shapiro
- Division of Rheumatology, Albany Medical Center, Albany, NY, USA; Steffens Scleroderma Foundation, Albany, NY, USA
| | - Elizabeth R Volkmann
- University of California, David Geffen School of Medicine, UCLA Scleroderma Program and UCLA CTD-ILD Program, Division of Rheumatology, Department of Medicine, Los Angeles, CA, USA
| | - Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center, New Orleans, USA; Tulane University School of Medicine, New Orleans, USA; University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs, New Orleans, USA; Louisiana State University School of Medicine, Section of Pulmonary Medicine, New Orleans, USA.
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14
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Rydwik E, Anmyr L, Regardt M, McAllister A, Zarenoe R, Åkerman E, Orrevall Y, Bragesjö M, Dahl O, Kemani MK, Nordstrand L, Ekman U, Holmström L, Nygren-Bonnier M. ReCOV: recovery and rehabilitation during and after COVID-19 - a study protocol of a longitudinal observational study on patients, next of kin and health care staff. BMC Sports Sci Med Rehabil 2021; 13:70. [PMID: 34193260 PMCID: PMC8243048 DOI: 10.1186/s13102-021-00299-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 06/10/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND The knowledge of the long-term consequences of covid-19 is limited. In patients, symptoms such as fatigue, decreased physical, psychological, and cognitive function, and nutritional problems have been reported. How the disease has affected next of kin, as well as staff involved in the care of patients with covid-19, is also largely unknown. The overall aim of this study is therefore three-fold: (1) to describe and evaluate predictors of patient recovery, the type of rehabilitation received and patients' experiences of specialized rehabilitation following COVID-19 infection; (2) to study how next of kin experienced the hospital care of their relative and their experiences of the psychosocial support they received as well as their psychological wellbeing; (3) to describe experiences of caring for patients with COVID-19 and evaluate psychological wellbeing, coping mechanisms and predictors for development of psychological distress over time in health care staff. METHODS This observational longitudinal study consists of three cohorts; patients, next of kin, and health care staff. The assessments for the patients consist of physical tests (lung function, muscle strength, physical capacity) and questionnaires (communication and swallowing, nutritional status, hearing, activities of daily living, physical activity, fatigue, cognition) longitudinally at 3, 6 and 12 months. Patient records auditing (care, rehabilitation) will be done retrospectively at 12 months. Patients (3, 6 and 12 months), next of kin (6 months) and health care staff (baseline, 3, 6, 9 and 12 months) will receive questionnaires regarding, health-related quality of life, depression, anxiety, sleeping disorders, and post-traumatic stress. Staff will also answer questionnaires about burnout and coping strategies. Interviews will be conducted in all three cohorts. DISCUSSION This study will be able to answer different research questions from a quantitative and qualitative perspective, by describing and evaluating long-term consequences and their associations with recovery, as well as exploring patients', next of kins' and staffs' views and experiences of the disease and its consequences. This will form a base for a deeper and better understanding of the consequences of the disease from different perspectives as well as helping the society to better prepare for a future pandemic.
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Affiliation(s)
- E Rydwik
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden.
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden.
| | - L Anmyr
- Women's Health and Allied Health Professionals Theme, Department of Social Work in Health, Karolinska University Hospital, Solna, Sweden
- Department of CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - M Regardt
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
| | - A McAllister
- Women's Health and Allied Health Professionals Theme, Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden
- CLINTEC, Division of Speech-Language Pathology, Karolinska Institutet, Stockholm, Sweden
| | - R Zarenoe
- Women's Health and Allied Health Professionals Theme, Department of Social Work in Health, Karolinska University Hospital, Solna, Sweden
| | - E Åkerman
- Perioperative Medicine and Intensive Care Function, Department of Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Y Orrevall
- Women's Health and Allied Health Professionals Theme, Medical Unit Clinical Nutrition, Karolinska University Hospital, Stockholm, Sweden
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - M Bragesjö
- Department of Clinical Neuroscience, Division of Psychology Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - O Dahl
- Perioperative Medicine and Intensive Care Function, Department of Intensive Care, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - M K Kemani
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - L Nordstrand
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - U Ekman
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden
| | - L Holmström
- Department of Clinical Neuroscience, Division of Psychology Karolinska Institutet, Stockholm, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Medical Psychology Karolinska University Hospital, Solna, Sweden
| | - M Nygren-Bonnier
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Solna, Sweden
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15
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Gillisdotter A, Regardt M, Månsson Lexell E. The "Managing Fatigue" programme - experiences shared by MS participants. Scand J Occup Ther 2021:1-10. [PMID: 33861175 DOI: 10.1080/11038128.2021.1905057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The "Managing Fatigue" (MF) programme can help people living with Multiple sclerosis (MS) manage fatigue in their everyday lives. The programme has been proven feasible with Swedish occupational therapists, but there is a lack of knowledge of how MS participants experience the programme, and what they learned from participating in the programme. AIM To describe how Swedish MS participants experience the content and structure of the Swedish MF programme, as well as what they learned from participating in the programme. MATERIAL AND METHODS Qualitative interviews were performed with nine MS participants, and data were analysed according to direct content analysis. RESULTS Participants experienced programme material was relevant, and they valued the structured sessions that utilised different teaching forms. Participants described the group format and the experienced course leader nurtured their learning process. They learned occupational skills to save energy, to re-value daily occupations, and initiated a process of change, but individual support is needed after programme completion. CONCLUSION AND SIGNIFICANCE Findings support programme feasibility among MS participants, and show the importance of being able to practice skills to handle fatigue in everyday life. Future studies should consider adding outcome measures focussing on engagement in occupations when evaluating programme effectiveness.
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Affiliation(s)
- Anna Gillisdotter
- Medical Unit Occupational Therapy and Physiotherapy, Function Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden.,Gillisdotter Caregivers Consulting AB, Upplaends Vaesby, Sweden
| | - Malin Regardt
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden.,Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund-Malmö, Sweden
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16
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Esfandiary T, Park JK, Alexanderson H, Regardt M, Needham M, de Groot I, Sarver C, Lundberg IE, de Visser M, Song YW, DiRenzo D, Bingham CO, Christopher-Stine L, Mecoli CA. Assessing the content validity of patient-reported outcome measures in adult myositis: A report from the OMERACT myositis working group. Semin Arthritis Rheum 2020; 50:943-948. [PMID: 32906029 DOI: 10.1016/j.semarthrit.2020.06.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/23/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the content validity of several patient-reported outcome measures (PROMs) in patients with idiopathic inflammatory myopathies (IIM). METHODS Seven individual PROM instruments were selected by the Outcome Measures in Rheumatology (OMERACT) Myositis Working Group relating to the following domains: pain, fatigue, physical function and physical activity. Twenty patients from the Johns Hopkins Myositis Center were selected for one-on-one face-to-face or phone interviews for cognitive interviewing of individual PROMs to assess comprehension and content validity. Additionally, patients were asked if they thought muscle symptoms, an area originally identified in qualitative studies, were encapsulated by the other four domains. RESULTS The majority of patients (>70%) felt that each of the instruments was clear, easy to read and understand, and could be used for assessment of its domain. Two-thirds (66%) of patients felt that 'muscle symptoms' were captured by the other domains. CONCLUSIONS We provided evidence to support adequate content validity for several PROMs. Further research is needed to determine whether 'muscle symptoms' warrant a separate domain.
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Affiliation(s)
- Tina Esfandiary
- Department of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Jin Kyun Park
- Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Helene Alexanderson
- Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine Solna, Rheumatology Unit, Karolinska Institutet, and Medical Unit Occupational Therapy and Physical therapy, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Malin Regardt
- Occupational Therapist, Department of Neurobiology, Care Sciences and Society Division of Occupational Therapy, Karolinska Institutet and Medical Unit Occupational Therapy and Physical therapy, Karolinska University Hospital, Solna, Stockholm, Sweden
| | - Merrilee Needham
- Dept Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Australia
| | | | | | - Ingrid E Lundberg
- Division of Rheumatology, Department of Medicine, Karolinska University, Hospital, Karolinska Institutet, Solna, Stockholm, Sweden; Center for Global health, University of Ottawa, Ottawa, ON, Canada
| | - Marianne de Visser
- Department of Neurology, Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Yeong Wook Song
- Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea
| | - Dana DiRenzo
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, 5200 Eastern Ave, MFL Bldg, Center Tower, Suite 4100, Baltimore 21224, MD, USA
| | - Clifton O Bingham
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, 5200 Eastern Ave, MFL Bldg, Center Tower, Suite 4100, Baltimore 21224, MD, USA
| | - Lisa Christopher-Stine
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, 5200 Eastern Ave, MFL Bldg, Center Tower, Suite 4100, Baltimore 21224, MD, USA
| | - Christopher A Mecoli
- Division of Rheumatology, Department of Medicine, Johns Hopkins University, 5200 Eastern Ave, MFL Bldg, Center Tower, Suite 4100, Baltimore 21224, MD, USA.
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17
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Regardt M, Mecoli CA, Park JK, de Groot I, Sarver C, Needham M, de Visser M, Shea B, Bingham CO, Lundberg IE, Song YW, Christopher-Stine L, Alexanderson H. OMERACT 2018 Modified Patient-reported Outcome Domain Core Set in the Life Impact Area for Adult Idiopathic Inflammatory Myopathies. J Rheumatol 2019; 46:1351-1354. [PMID: 30770504 DOI: 10.3899/jrheum.181065] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To present and vote on a myositis modified patient-reported outcome core domain set in the life impact area at the Outcome Measures in Rheumatology (OMERACT) 2018. METHODS Based on results from international focus groups and Delphi surveys, a draft core set was developed. RESULTS Domains muscle symptoms, fatigue, level of physical activity, and pain reached ≥ 70% consensus and were mandatory to assess in all trials. Domains lung, joint, and skin symptoms were mandatory in specific circumstances. This core set was endorsed by > 85% at OMERACT 2018. CONCLUSION We propose a life impact core set for patients with idiopathic inflammatory myopathies and will proceed with instrument selections.
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Affiliation(s)
- Malin Regardt
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada. .,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors.
| | - Christopher A Mecoli
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Jin Kyun Park
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Ingrid de Groot
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Catherine Sarver
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Merrilee Needham
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Marianne de Visser
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Beverly Shea
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Clifton O Bingham
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Ingrid E Lundberg
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Yeong W Song
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Lisa Christopher-Stine
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
| | - Helene Alexanderson
- From the Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine, Karolinska Institutet; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea; Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, Perth; The Notre Dame University Fremantle, Fremantle, Australia; Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam, the Netherlands; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada.,M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; I. de Groot, Patient Research Partner; C. Sarver, Patient Research Partner; M. Needham, MD, Division of Rheumatology, Fiona Stanley Hospital, Institute for Immunology and Infectious Diseases, Murdoch University, and The Notre Dame University; M. de Visser, MD, PhD, Amsterdam UMC, University of Amsterdam, Department of Neurology, Amsterdam Neuroscience; B. Shea, MSN, Center for Global Health, University of Ottawa; C.O. Bingham III, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska Institutet; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; H. Alexanderson, PhD, Physiotherapist, Department of Neurobiology, Care Science and Society, Division of Physiotherapy and Department of Medicine Solna, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital. M. Regardt and Dr. C. Mecoli are co-first authors
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Mecoli CA, Park JK, Alexanderson H, Regardt M, Needham M, de Groot I, Sarver C, Lundberg IE, Shea B, de Visser M, Song YW, Bingham CO, Christopher-Stine L. Perceptions of Patients, Caregivers, and Healthcare Providers of Idiopathic Inflammatory Myopathies: An International OMERACT Study. J Rheumatol 2018; 46:106-111. [PMID: 30219767 DOI: 10.3899/jrheum.180353] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Patient-reported outcome measures (PROM) that incorporate the patient perspective have not been well established in idiopathic inflammatory myopathies (IIM). As part of our goal to develop IIM-specific PROM, the Outcome Measures in Rheumatology (OMERACT) Myositis special interest group sought to determine which aspects of disease and its effects are important to patients and healthcare providers (HCP). METHODS Based on a prior qualitative content analysis of focus groups, an initial list of 24 candidate domains was constructed. We subsequently conducted an international survey to identify the importance of each of the 24 domains to be assessed in clinical research. Patients with IIM, their caregivers, and HCP treating IIM completed the survey. RESULTS In this survey, a total of 638 respondents completed the survey, consisting of 510 patients, 101 HCP, and 27 caregivers from 48 countries. Overall, patients were more likely to rank "fatigue," "cognitive impact," and "difficulty sleeping" higher compared with HCP, who ranked "joint symptoms," "lung symptoms," and "dysphagia" higher. Both patients and providers rated muscle symptoms as their top domain. In general, patients from different countries were in agreement on which domains were most important. One notable exception was that patients from Sweden and the Netherlands ranked lung symptoms significantly higher compared to other countries including the United States and Australia (mean weighted rankings of 2.86 and 2.04 vs 0.76 and 0.80, respectively; p < 0.0001). CONCLUSION Substantial differences exist in how IIM is perceived by patients compared to HCP, with different domains prioritized. In contrast, patients' ratings across the world were largely similar.
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Affiliation(s)
- Christopher A Mecoli
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea. .,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors.
| | - Jin Kyun Park
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Helene Alexanderson
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Malin Regardt
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Merrilee Needham
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Ingrid de Groot
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Catherine Sarver
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Ingrid E Lundberg
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Beverley Shea
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Marianne de Visser
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Yeong Wook Song
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Clifton O Bingham
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
| | - Lisa Christopher-Stine
- From the Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA; Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Department of Learning, Informatics and Medical Education, Karolinska Institutet, Solna, Sweden; Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University, Murdoch, Australia; Patient Research Partner, the Netherlands and USA; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, Karolinska Institutet, Solna, Sweden; Center for Global Health, University of Ottawa, Ottawa, Ontario, Canada; Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea.,C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Medicine, Rheumatology Unit, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Needham, MD, Department of Neurology, Fiona Stanley Hospital, IIID Murdoch University and Notre Dame University; I. de Groot, Patient Research Partner, the Netherlands;C. Sarver, Patient Research Partner, USA; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Karolinska Institutet; B. Shea, MSN, Center for Global Health, University of Ottawa; M. de Visser, MD, Department of Neurology, Academic Medical Center, University of Amsterdam; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University. Dr. Mecoli and Dr. Park are co-first authors
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Alexanderson H, Regardt M, Ottosson C, Alemo Munters L, Dastmalchi M, Dani L, Lundberg IE. Muscle Strength and Muscle Endurance During the First Year of Treatment of Polymyositis and Dermatomyositis: A Prospective Study. J Rheumatol 2018; 45:538-546. [DOI: 10.3899/jrheum.161183] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
Abstract
Objective.To investigate muscle impairment (isometric and dynamic) and disease activity during the first year after diagnosis of polymyositis (PM) and dermatomyositis (DM), and to study the relationship between muscle impairment, patient-reported health, and disease activity.Methods.Seventy-two patients enrolled in the Swedish Myositis Register, 2003–2010, were followed prospectively. The Manual Muscle test (MMT-8; isometric muscle strength), the Functional Index of myositis test (FI-2; dynamic, repetitive muscle function), and disease activity (6-item core set) were retrieved at the time of diagnosis, and after 6 and 12 months. Self-reported health (Medical Outcomes Study Short Form-36; SF-36) was retrieved at 12 months.Results.At the time of diagnosis, median (Q1–Q3) for the FI-2 was 27.2% (7.9–60.5%) of maximal score compared to 93.8% (92.5–98.8%) of maximal MMT-8. At 12 months, the FI-2 and the MMT-8 improved to 29.4% (16.5–60.7%; p < 0.05) and 96.1% (88.1–99.4%), respectively (p < 0.01). At 12 months, 45% of patients improved ≥ 20%, and 27% worsened ≥ 20% in FI-2 score, while 10% improved ≥ 20% in MMT-8. Physician’s global visual analog scale (VAS), Health Assessment Questionnaire, and creatine phosphokinase levels improved significantly at 12 months (p < 0.05–0.001) while patient’s global and extramuscular VAS remained unchanged. The SF-36 physical function correlated strongly with the FI-2 (rs = 0.74; CI 0.55–0.85) and moderately with the MMT (rs = 0.54; CI 0.27–0.73), with lower correlations between muscle function and other SF-36 domains.Conclusion.Patients with PM/DM were characterized by impaired dynamic repetitive muscle function (DRMF) that correlated well with patient-reported physical function. Assessment of DRMF adds information regarding muscle impairment in these patients.
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Park JK, Mecoli CA, Alexanderson H, Regardt M, Christopher-Stine L, Casal-Domínguez M, de Groot I, Sarver C, Lundberg IE, Bingham CO, Song YW. Advancing the Development of Patient-reported Outcomes for Adult Myositis at OMERACT 2016: An International Delphi Study. J Rheumatol 2017; 44:1944. [PMID: 29196552 DOI: 10.3899/jrheum.161252.c1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Park JK, Mecoli CA, Alexanderson H, Regardt M, Christopher-Stine L, Casal-Domínguez M, de Groot I, Sarver C, Lundberg IE, Bingham CO, Song YW. Advancing the Development of Patient-reported Outcomes for Adult Myositis at OMERACT 2016: An International Delphi Study. J Rheumatol 2017; 44:1683-1687. [PMID: 28765245 DOI: 10.3899/jrheum.161252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To define a set of core patient-reported domains and respective instruments for use in idiopathic inflammatory myopathies (IIM). Previously, we reported a systematic literature review on patient-reported outcomes (PRO) in IIM followed by conducting international focus groups to elicit patient perspectives of myositis symptoms and effects. METHODS Based on qualitative content analysis of focus groups, an initial list of 26 candidate domains was constructed. We subsequently conducted an international modified Delphi survey to identify the importance of each of the 26 domains. Participants were asked to rate each domain on a scale of 0-10 (0 = not important, 10 = very important). RESULTS In this first round of the Delphi survey, 643 patients participated from the United States (n = 543), Sweden (n = 49), and South Korea (n = 51). Of the 26 domains, 19 (73%) were rated of high importance (≥ 7/10). The top 5 domains were muscle symptoms, fatigue, interactions with healthcare, medication side effects, and pain. During Outcome Measures in Rheumatology (OMERACT) 2016, we discussed the goal for ultimate reduction in the number of domains and the importance of considering representation of healthcare providers from other specialties, caregivers, representatives of pharmaceutical industries, and regulatory authorities in the next rounds of Delphi to represent broader perspectives on IIM. CONCLUSION Further prioritization and a reduction in the number of domains will be needed for the next Delphi. At the next biennial OMERACT meeting, we aim to present and seek voting on a Myositis Preliminary PRO Core Set to enable ultimate measure selection and development.
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Affiliation(s)
- Jin Kyun Park
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Christopher A Mecoli
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Helene Alexanderson
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Malin Regardt
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Lisa Christopher-Stine
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - María Casal-Domínguez
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Ingrid de Groot
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Catherine Sarver
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Ingrid E Lundberg
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Clifton O Bingham
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work
| | - Yeong Wook Song
- From the Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, and Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, South Korea; Department of Neurology, Care Science and Society, Division of Physiotherapy, and Department of Learning, Informatics and Medical Education, Karolinska Institutet; Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University Hospital in Solna, Sweden; Division of Rheumatology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA. .,J.K. Park, MD, Division of Rheumatology, Department of Internal Medicine, Seoul National University Hospital; H. Alexanderson, PhD, Physiotherapist, Department of Neurology, Care Science and Society, Division of Physiotherapy, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; M. Regardt, PhD, Occupational Therapist, Department of Learning, Informatics and Medical Education, Karolinska Institutet, and Function Area Occupational Therapy and Physical Therapy, Allied Health Professionals Function, Karolinska University Hospital; L. Christopher-Stine, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C.A. Mecoli, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; M.C. Domínguez, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; C. Sarver, Patient Research Partner; I. de Groot, Patient Research Partner; I.E. Lundberg, MD, PhD, Division of Rheumatology, Rheumatology Unit, Department of Medicine, Karolinska University, and Hospital in Solna, Karolinska Institutet; C.O. Bingham 3rd, MD, Division of Rheumatology, Department of Medicine, Johns Hopkins University; Y.W. Song, MD, PhD, Division of Rheumatology, Department of Internal Medicine, Medical Research Center, College of Medicine, Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University. Dr. Park and Dr. Mecoli contributed equally to this work.
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Regardt M, Welin Henriksson E, Sandqvist J, Lundberg IE, Schult ML. Work ability in patients with polymyositis and dermatomyositis: An explorative and descriptive study. Work 2016; 53:265-77. [PMID: 26409371 DOI: 10.3233/wor-152127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Polymyositis (PM) and dermatomyositis (DM) are rare, chronic inflammatory diseases leading to muscle weakness and low muscle endurance. The muscle weakness may lead to restrictions in daily activities and low health-related quality of life. OBJECTIVES This study aimed to investigate the work situation, work ability, work-related risk factors, and influence of the physical and psycho-social work environment in patients with PM and DM. METHODS Patients with PM/DM were assessed using the Work Ability Index (WAI), and the Work Environment Impact Scale (WEIS). RESULTS Forty-eight patients (PM n = 25 and DM n = 23) participated (women/men: 29/19) with a mean age of 54 years (range 28-67 years, SD.10) and mean disease duration of nine years (SD.9). Forty-four percent worked full-time, 31% part-time and 25% were on full-time sick leave. More than 50% self-rated work ability as "poor" or "less good". Physically strenuous work components were present "quite to very often" in 23-79% and more in patients on sick leave ≥ 2 years. For those working, the interfering factors in the work environment concerned task and time demands. Supporting factors concerned meaning of work, interactions with co-workers and others. Self-rated work ability correlated moderately-highly positive with percentage of full-time employment, work-related risk factors and opportunities and constraints in the work environment. CONCLUSIONS Poor self-rated work ability is common in patients with PM/DM indicating a need to identify interfering risk factors and support patients to enhance work performance.
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Affiliation(s)
- Malin Regardt
- Department of Occupational Therapy Karolinska University Hospital Solna, Sweden.,Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden
| | - Elisabet Welin Henriksson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Sweden.,Department of Medicine, Rheumatology Unit, Karolinska University Hospital at Solna, Karolinska Institutet, Stockholm, Sweden
| | - Jan Sandqvist
- Department of Social and Welfare Studies, Faculty of Health Sciences, Linkoping University, Norrkoping, Sweden
| | - Ingrid E Lundberg
- Department of Medicine, Rheumatology Unit, Karolinska University Hospital at Solna, Karolinska Institutet, Stockholm, Sweden
| | - Marie-Louise Schult
- Karolinska Institutet, Department of Clinical Sciences, Danderyd Hospital, Division of Rehabilitation Medicine, Stockholm, Sweden.,The Rehabilitation Medicine University Clinic, Danderyd Hospital, Stockholm, Sweden
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Leclair V, Regardt M, Wojcik S, Hudson M. Health-Related Quality of Life (HRQoL) in Idiopathic Inflammatory Myopathy: A Systematic Review. PLoS One 2016; 11:e0160753. [PMID: 27504827 PMCID: PMC4978480 DOI: 10.1371/journal.pone.0160753] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/25/2016] [Indexed: 11/18/2022] Open
Abstract
Health-related quality of life (HRQoL) is a research priority in chronic diseases. We undertook a systematic review (registration #CRD42015024939) to identify, appraise and synthesize the evidence relating to HRQoL in idiopathic inflammatory myopathies (IIM). A comprehensive search was conducted in August 2015 using CINAHL, EMBase and Pubmed to identify studies reporting original data on HRQoL in IIM using generic HRQoL instruments. Characteristics of samples and results from selected studies were extracted and appraised using a standardized approach. Qualitative synthesis of the results was performed. Ten studies including a total of 654 IIM subjects were included in this systematic review. HRQoL was significantly impaired in all subsets of IIM compared with the general population. Disease activity, disease damage and chronic disease course were associated with poorer HRQoL. Insufficient or conflicting results were found in associations between clinical features, treatment, disease duration and mood or illness perception, and HRQoL in IIM. This study suggests that HRQoL is impaired in IIM. However, due to the paucity and heterogeneity of the evidence to date, robust estimates are lacking and significant knowledge gaps persist. There is a need for studies that systematically investigate the correlates and trajectory of HRQoL in IIM.
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Affiliation(s)
- Valérie Leclair
- Department of Medicine, Division of Rheumatology, McGill University, Montreal, Canada
- * E-mail:
| | - Malin Regardt
- Department of Occupational Therapy, Karolinska University Hospital, Stockholm, Sweden
- Department of Learning, Division of Informatics and Medical Education, Karolinska Institutet, Stockholm, Sweden
| | - Sophie Wojcik
- Department of Medicine, Division of Rheumatology, McGill University, Montreal, Canada
| | - Marie Hudson
- Department of Medicine, Division of Rheumatology, McGill University, Montreal, Canada
- Department of Medicine, Division of Rheumatology, Jewish General Hospital, Montreal, Canada
- Lady Davis Institute for Medical Research, Division of Clinical Epidemiology, Jewish General Hospital, Montreal, Canada
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Regardt M, Welin Henriksson E, Sandqvist J, Lundberg I, Schult ML. AB1248-HPR Work Ability in Patients with Polymyositis and Dermatomyositis: An Explorative and Descriptive Study. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Regardt M, Pettersson S, Svantesson S, Tarre T, Wretbring K, Ernestam S. OP0006 Can An E-Health Service Enhance Communication in Early Arthritis? Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Regardt M, Basharat P, Christopher-Stine L, Sarver C, Björn A, Lundberg IE, Wook Song Y, Bingham CO, Alexanderson H. Patients’ Experience of Myositis and Further Validation of a Myositis-specific Patient Reported Outcome Measure — Establishing Core Domains and Expanding Patient Input on Clinical Assessment in Myositis. Report from OMERACT 12. J Rheumatol 2015; 42:2492-5. [DOI: 10.3899/jrheum.141243] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.The Outcome Measures in Rheumatology (OMERACT) myositis working group was established to examine patient-reported outcomes (PRO) as well as to validate patient-reported outcome measures (PROM) in myositis.Methods.Qualitative studies using focus group interviews and cognitive debriefing of the myositis-specific Myositis Activities Profile (MAP) were used to explore the experience of adults living with polymyositis (PM) and dermatomyositis (DM).Results.Preliminary results underscore the importance of patient input in the development of PROM to ensure content validity. Results from multicenter focus groups indicate the range of symptoms experienced including pain, fatigue, and impaired cognitive function, which are not currently assessed in myositis. Preliminary cognitive debriefing of the MAP indicated that while content was deemed relevant and important, several activities were not included; and that questionnaire construction and wording may benefit from revision. A research agenda was developed to continue work toward optimizing PRO assessment in myositis with 2 work streams. The first would continue to conduct and analyze focus groups until saturation in the thematic analysis was achieved to develop a framework that encompassed the patient-relevant aspects of myositis. The second would continue cognitive debriefing of the MAP to identify potential areas for revision. There was agreement that further work would be needed for inclusion body myositis and juvenile dermatomyositis, and that the inclusion of additional contributors such as caregivers and individuals from the pharmaceutical/regulatory spheres would be desirable.Conclusions.The currently used PROM do not assess symptoms or the effects of disease that are most important to patients; this emphasizes the necessity of patient involvement. Our work provides concrete examples for PRO identification.
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Regardt M, Schult ML, Axelsson Y, Aldehag A, Alexanderson H, Lundberg I, Welin Henriksson E. AB1178-HPR Hand Exercise Intervention in Patients with Polymyositis and Dermatomyositis: A Pilot Study. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.2230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Regardt M, Schult ML, Axelsson Y, Aldehag A, Alexanderson H, Lundberg IE, Henriksson EW. Hand exercise intervention in patients with polymyositis and dermatomyositis: a pilot study. Musculoskeletal Care 2014; 12:160-72. [PMID: 24623733 DOI: 10.1002/msc.1069] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE The aim of the present study was to develop a 12-week hand exercise intervention for patients with polymyositis (PM) and dermatomyositis (DM) and evaluate adherence, patients' opinions of the programme design and overall feasibility, and the effect on hand function and activity limitation after the intervention. METHOD A pilot hand exercise intervention was conducted on a convenience sample of 15 patients with reduced handgrip strength and established, inactive PM and DM. Acceptable adherence was set at 75%. The programme was evaluated based on patients' opinions regarding exertion, the movements involved and overall feasibility. Hand- and pinch-grip strength, grip ability, dexterity and activity limitation were assessed. RESULTS Eleven of 15 patients completed the intervention, with acceptable adherence of 78-100%. Measures of handgrip strength, dexterity and activity limitation were reduced at baseline compared with normative data from the literature. Throughout the intervention, rates of perceived exertion were scored between 'moderate' and 'fairly strong'. Finger abduction and adduction were excluded from the hand exercise programme because they were not feasible to perform. Repetitions of the exercise increased gradually to a maximum of 30 per movement. Patients regarded this as too time-consuming and suggested ten repetitions daily or 10-20 repetitions 2-4 times per week. There were some individual, clinically meaningful improvements in hand function and activity limitation. A comparison between baseline and after the intervention showed that the three-jaw (tripod) pinch-grip strength (left hand) had increased (p < 0.007; z = -2.7). CONCLUSION A hand exercise programme was found to be feasible to perform by patients with established PM or DM. The effect was limited, with few individual improvements in hand function and activity limitation, indicating a need to increase the resistance in the movements and to limit the duration of each exercise session.
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Affiliation(s)
- Malin Regardt
- Department of Occupational Therapy, Karolinska University Hospital, Solna, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
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Alemo Munters L, Dastmalchi M, Andgren V, Emilson C, Bergegård J, Regardt M, Johansson A, Orefelt Tholander I, Hanna B, Lidén M, Esbjörnsson M, Alexanderson H. Improvement in health and possible reduction in disease activity using endurance exercise in patients with established polymyositis and dermatomyositis: a multicenter randomized controlled trial with a 1-year open extension followup. Arthritis Care Res (Hoboken) 2014; 65:1959-68. [PMID: 23861241 DOI: 10.1002/acr.22068] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 06/21/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the effects of a 12-week endurance exercise program on health, disability, VO2 max, and disease activity in a multicenter randomized controlled trial in patients with established polymyositis (PM) and dermatomyositis (DM), and to evaluate health and disability in a 1-year open extension study. METHODS Patients were randomized into a 12-week endurance exercise program group (EG; n = 11) or a control group (CG; n = 10). Assessments of health (Short Form 36 [SF-36]), muscle performance (5 voluntary repetition maximum [5 VRM]), activities of daily living (ADL), patient preference (McMaster Toronto Arthritis Patient Preference Disability Questionnaire), VO2 max, and disease activity (International Myositis Assessment and Clinical Studies criteria of improvement of the 6-item core set) were performed at 0 and 12 weeks. Disability assessments were performed again at 52 weeks in an open extension period. All assessments were performed by blinded observers. RESULTS The EG improved compared to the CG in SF-36 physical function and vitality (P = 0.010 and P = 0.046, respectively), ADL score (P = 0.035), 5 VRM (P = 0.026), and VO2 max (P = 0.010). More patients in the EG (7 of 11) were responders with reduced disease activity compared to none in the CG (P = 0.002). Correlations between VO2 max and SF-36 physical function were 0.90 and 0.91 at 0 and 12 weeks, respectively (P < 0.05). The EG improvement in 5 VRM was sustained up to 52 weeks compared to baseline (5.7 kg; P < 0.001), but not in ADL score or SF-36. CONCLUSIONS Endurance exercise improves health and may reduce disease activity in patients with established PM/DM. This potentially could be mediated through improved aerobic fitness. The results also indicate sustained muscle strength up to 1 year after a supervised program.
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Affiliation(s)
- Li Alemo Munters
- Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
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Regardt M, Lundberg IE, Sandqvist J, Welin Henriksson E, Schult ML. SAT0579-HPR The Work Ability in Patients with Polymy- and Dermatomyositis is Affected: a Cross-Sectional Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Regardt M, Schult ML, Alexanderson H, Alemo Munters L, Dastmalchi M, Dani L, Lidén M, Lundsten K, Lundberg IE, Welin Henriksson E. SAT0580-HPR Women and Men with Polymyositis and Dermatomyositis have Reduced Grip Force and Health Related Quality of Life at Time of Diagnosis: a Registry Study. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.2304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Regardt M, Welin Henriksson E, Lundberg I. AB1459-HPR Despite low disease activity patients with poly- and dermatomyositis perceive activity limitation, reduced grip force and quality of life longitudinally. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Regardt M, Welin Henriksson E, Alexanderson H, Lundberg IE. Patients with polymyositis or dermatomyositis have reduced grip force and health-related quality of life in comparison with reference values: an observational study. Rheumatology (Oxford) 2010; 50:578-85. [PMID: 21097879 DOI: 10.1093/rheumatology/keq356] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES The aims of this study were to investigate hand function in PM and DM patients and compare this with reference values in healthy individuals and also to investigate if hand function correlated with activity performance and health-related quality of life. METHODS An observational cross-sectional study was performed in 18 women and 13 men with PM or DM with established disease. Grip force and hand mobility were assessed by Grippit and Escola Paulista de Medicina-Range of Motion scale. Activity performance was measured with myositis activities profile and health-related quality of life by short form-36 (SF-36). RESULTS Women and men with PM and DM with mean disease duration of 6.8 (5.5) years had a significantly lower grip force than gender- and age-matched healthy individuals (women 71% and men 60%). They also had significantly lower mean values in all dimensions of the health-related quality of life instrument SF-36 compared with the Swedish population. In patients with PM and DM, the grip force correlated significantly with the ability to perform domestic activities. In women with PM and DM, the grip force correlated significantly with the health-related quality of life dimensions vitality and mental health. There were no significant differences between patients with PM and DM regarding grip force, hand mobility, activity performance or health-related quality of life. CONCLUSIONS Patients with PM or DM have reduced grip force that could influence activity performance and health-related quality of life.
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Affiliation(s)
- Malin Regardt
- Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Huddinge, Sweden.
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