Influence of Social Support, Financial Status, and Lifestyle on the Disparity Between Inflammation and Disability in Rheumatoid Arthritis.

Autor: Gwinnutt JM; University of Manchester, Manchester, UK., Norton S; King's College London, London, UK., Hyrich KL; University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK., Lunt M; University of Manchester, Manchester, UK., Combe B; University of Montpellier, Montpellier, France., Rincheval N; University of Montpellier, Montpellier, France., Ruyssen-Witrand A; Hôpital Purpan and Université Toulouse III-Paul Sabatier University, Toulouse, France., Fautrel B; Sorbonne University, Assistance Publique Hôpitaux de Paris, Pitie Salpetriere Hospital, and Pierre Louis Institute of Epidemiology and Public Health, Paris, France., McWilliams DF; University of Nottingham and NIHR Nottingham Biomedical Research Centre, Nottingham, UK., Walsh DA; University of Nottingham and NIHR Nottingham Biomedical Research Centre, Nottingham, UK, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-in-Ashfield, UK., Nikiphorou E; King's College and King's College Hospital, London, UK., Kiely PDW; St. George's University Hospitals NHS Foundation Trust and St. George's University of London, London, UK., Young A; University of Hertfordshire, Hatfield, UK., Chipping JR; University of East Anglia and Norfolk and Norwich University Hospitals NHS Trust, Norwich, UK., MacGregor A; University of East Anglia and Norfolk and Norwich University Hospitals NHS Trust, Norwich, UK., Verstappen SMM; University of Manchester and Manchester University NHS Foundation Trust, Manchester, UK.
Jazyk: angličtina
Zdroj: Arthritis care & research [Arthritis Care Res (Hoboken)] 2023 May; Vol. 75 (5), pp. 1026-1035. Date of Electronic Publication: 2022 Dec 28.
DOI: 10.1002/acr.24996
Abstrakt: Objective: To investigate how social support, financial status, and lifestyle influence the development of excess disability in rheumatoid arthritis (RA).
Methods: Data were obtained from the Étude et Suivi des Polyarthrites Indifférenciées Récentes (ESPOIR) cohort study of people with RA. A previous analysis identified groups with similar inflammation trajectories but markedly different disability over 10 years; those in the higher disability trajectory groups were defined as having "excess disability." Self-reported data regarding contextual factors (social support, financial situation, lifestyle) were obtained from participants, and they completed patient-reported outcome measures (pain, fatigue, anxiety, depression) at baseline. The direct effect of the contextual factors on excess disability and the effect mediated by patient-reported outcome measures were assessed using structural equation models. Findings were validated in 2 independent data sets (Norfolk Arthritis Register [NOAR], Early Rheumatoid Arthritis Network [ERAN]).
Results: Of 538 included ESPOIR participants (mean age ± SD 48.3 ± 12.2 years; 79.2% women), 200 participants (37.2%) were in the excess disability group. Less social support (β = 0.17 [95% confidence interval (95% CI) 0.08, 0.26]), worse financial situation (β = 0.24 [95% CI 0.14, 0.34]), less exercise (β = 0.17 [95% CI 0.09-0.25]), and less education (β = 0.15 [95% CI 0.06, 0.23]) were associated with excess disability group membership; smoking, alcohol consumption, and body mass index were not. Fatigue and depression mediated a small proportion of these effects. Similar results were seen in NOAR and ERAN.
Conclusion: Greater emphasis is needed on the economic and social contexts of individuals with RA at presentation; these factors might influence disability over the following decade.
(© 2022 The Authors. Arthritis Care & Research published by Wiley Periodicals LLC on behalf of American College of Rheumatology.)
Databáze: MEDLINE
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