IMPACT OF SOCIO-DEMOGRAPHIC AND CLINICAL CHARACTERISTICS ON FUNCTIONAL STATUS AND HEALTH OF PATIENTS WITH RHEUMATOLOGICAL AND AUTOIMMUNE DISEASES; PRESENTING IN RHEUMATOLOGY OPD OF A TERTIARY CARE HOSPITAL

Main Article Content

Asif Islam
Vivek Kumar
Raj Kanwal
Dr Aman Ullah Khan Kakar
Sadia Iram
Amina Gul Shehzar Khan
Nigar Hashmi
Faiyyaz ur Rehman
Dr Jaisingh Rajput

Keywords

Arthritis, Biologic therapy, Health outcomes, Patients awareness, Rheumatological disorders.

Abstract

Background: Rheumatological and autoimmune diseases affect a substantial portion of world's population and had substantial impact on functional status and health-related outcome of affected individuals.


Objectives: We investigated the influence of socio-demographic and clinical factors on the functional status and health of patients with rheumatological and autoimmune diseases.


Methods: We conducted a cross-sectional survey of 384 patients with rheumatological and autoimmune diseases to examine relationships between socio-demographic and clinical variables, functional status, and patients’ health. We collected data on structured questionnaire pertaining to socio-demographics of patients and assessment of functional health status of patients was done using DAS-28 and MHAQ scoring charts.


Results: Majority of patients (73.69%) were females (p<0.05). Age range of patients was 18-68 years with mean 58.32+9.18 years. 52 patients (13.54%) had a DAS-28 score between 2.6 and 3.2, 218 patients (56.77%) had a DAS-28 score between 3.2 and 5.1, and 98 patients (25.52%) had a DAS-28 score higher than 5.1. Between 0 and 8 MHAQ scores, there were 89 (23.17%) patients, between 9 and 16 patients had 163 (42.44%), between 17 and 24 patients had 109 (28.38%), and between 25 and 32 patients had 23 (5.98%).


Conclusion: Socio-demographic and clinical factors played significant role in determining the functional status and overall health of patients with rheumatological and autoimmune diseases. Older age, a lower literacy level, prolonged disease and occurrence of multiple clinical characteristics were associated with a abridged functional and health-status of patients’ life.

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References

1. Shin YH, Shin JI, Moon SY, Jin HY, Kim SY, Yang JM, Cho SH, Kim S, Lee M, Park Y, Kim MS, Won HH, Hong SH, Kronbichler A, Koyanagi A, Jacob L, Smith L, Lee KH, Suh DI, Lee SW, Yon DK. Autoimmune inflammatory rheumatic diseases and COVID-19 outcomes in South Korea: a nationwide cohort study. Lancet Rheumatol. 2021 Oct;3(10):e698-e706.
2. Hedar AM, Stradner MH, Roessler A, Goswami N. Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis. J Clin Med. 2021 Sep 27;10(19):4427.
3. Lwin, M.N., Serhal, L., Holroyd, C. et al. Rheumatoid Arthritis: The Impact of Mental Health on Disease: A Narrative Review. Rheumatol Ther 7, 457–471 (2020).
4. Al-Jabi SW, Seleit DI, Badran A, Koni A, Zyoud SH. Impact of socio-demographic and clinical characteristics on functional disability and health-related quality of life in patients with rheumatoid arthritis: a cross-sectional study from Palestine. Health Qual Life Outcomes. 2021 Oct 13;19(1):241.
5. Hassen, L.M., Albarrak, R.A., Albahlal, R.A. et al. Functional and psychosocial impact of COVID-19 pandemic on rheumatic patients’ quality of life in Saudi Arabia. Qual Life Res 31, 3229–3239 (2022).
6. Nasir N, Majid H, Khan AH, Awan S, Mehmood Riaz M. Disease activity correlates and functionality in patients with rheumatoid arthritis - real-world experience from a South Asian country. Reumatologia. 2022;60(3):183-191.
7. Furman D, Campisi J, Verdin E, Carrera-Bastos P, Targ S, Franceschi C, Ferrucci L, Gilroy DW, Fasano A, Miller GW, Miller AH, Mantovani A, Weyand CM, Barzilai N, Goronzy JJ, Rando TA, Effros RB, Lucia A, Kleinstreuer N, Slavich GM. Chronic inflammation in the etiology of disease across the life span. Nat Med. 2019 Dec;25(12):1822-1832.
8. Busby AD, Wason J, Pratt AG, Young A, Isaacs JD, Nikiphorou E.The role of comorbidities alongside patient and disease characteristics in long-term disease activity in RA using UK inception cohort data, Rheumatology. 2022;61(11):4297–4304.
9. Coates LC, FitzGerald O, Helliwell PS, Paul C. Psoriasis, psoriatic arthritis, and rheumatoid arthritis: Is all inflammation the same? Seminars in Arthritis and Rheumatism. 2016;46(3):291-304.
10. Niccoli L, Nannini C, Blandizzi C, Mantarro S, Mosca M, Di Munno O, Goletti D, Benucci M, Gobbi FL, Cassarà E, Kaloudi O, Cantini F. Personalization of biologic therapy in patients with rheumatoid arthritis: less frequently accounted choice-driving variables. Ther Clin Risk Manag. 2018 Oct 24;14:2097-2111.
11. Taylor PC, Alten R, Reino JJG, Caporali R, Bertin P, Sullivan E, Wood R, Piercy J, Vasilescu R, Spurden D, Alvir J, Tarallo M. Factors influencing the use of biologic therapy and adoption of treat-to-target recommendations in current European rheumatology practice. Patient Prefer Adherence. 2018 Oct 4;12:2007-2014.
12. Liu E, Perl A. Pathogenesis and treatment of autoimmune rheumatic diseases. Curr Opin Rheumatol. 2019 May;31(3):307-315.
13. Coras R, Sturchio GA, Bru MB, Fernandez AS, Farietta S, Badia SC, Diez BR, de Agustín de Oro JJ. Analysis of the correlation between disease activity score 28 and its ultrasonographic equivalent in rheumatoid arthritis patients. Eur J Rheumatol. 2020 Jul;7(3):118-123.
14. Hansen JIM, Andreasen AR, van Bui HMN, Emamifar A. The Reliability of Disease Activity Score in 28 Joints-C-Reactive Protein Might Be Overestimated in a Subgroup of Rheumatoid Arthritis Patients, When the Score Is Solely Based on Subjective Parameters: A Cross-sectional, Exploratory Study. J Clin Rheumatol. 2017 Mar;23(2):102-106.
15. Maska L, Anderson J, Michaud K. Measures of functional status and quality of life in rheumatoid arthritis: Health Assessment Questionnaire Disability Index (HAQ), Modified Health Assessment Questionnaire (MHAQ), Multidimensional Health Assessment Questionnaire (MDHAQ), Health Assessment Questionnaire II (HAQ-II), Improved Health Assessment Questionnaire (Improved HAQ), and Rheumatoid Arthritis Quality of Life (RAQoL). Arthritis Care Res. 2011;63:S4-S13.
16. Kumaradev S, Roux C, Sellam J, Perrot S, Pham T, Dugravot A, Molto A. Socio-demographic determinants in the evolution of pain in inflammatory rheumatic diseases: results from ESPOIR and DESIR cohorts. Rheumatology (Oxford). 2022 Apr 11;61(4):1496-1509.
17. Bai B, Chen M, Fu L, Liu H, Jin L, Wei T, Xin F. Quality of life and influencing factors of patients with rheumatoid arthritis in Northeast China. Health Qual Life Outcomes. 2020;18(1):119.
18. Karimi S, Yarmohammadian MH, Shokri A, Mottaghi P, Qolipour K, Kordi A, Bahman Ziari N. Predictors and effective factors on quality of life among Iranian patients with rheumatoid arthritis. Mater Sociomed. 2013;25(3):158–62.
19. Matcham F, Scott IC, Rayner L, Hotopf M, Kingsley GH, Norton S, Scott DL, Steer S. The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum. 2014;44(2):123–30.
20. Guaracha-Basa´ñez GA, Contreras-Ya´ñez I, Herna´ndez-Molina G, Estrada-Gonza´lez VA, Pacheco-Santiago LD, Valverde-Herna´ndez SS, et al. (2022) Quality of life of patients with rheumatic diseases during the COVID-19 pandemic: The biopsychosocial path. PLoS ONE 17(1): e0262756.
21. Bae SC, Lee YH, Bae SC. Causal relationship between years of education and the occurrence of rheumatoid arthritis. Postgrad Med J 2019;95(1125):378–81.
22. Gorter A, Bakker MM, ten Klooster PM, Boonen A, Vonkeman HE. The impact of health literacy: associations with disease activity and medication prescription in patients with rheumatoid arthritis, Rheumatol. 2023;kead094.

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