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dc.contributor.authorBusby, Amanda
dc.contributor.authorWason, James
dc.contributor.authorPratt, Arthur
dc.contributor.authorYoung, Adam
dc.contributor.authorIsaacs, John
dc.contributor.authorNikiphorou, Elena
dc.date.accessioned2021-09-30T12:00:01Z
dc.date.available2021-09-30T12:00:01Z
dc.date.issued2021-07-24
dc.identifier.citationBusby , A , Wason , J , Pratt , A , Young , A , Isaacs , J & Nikiphorou , E 2021 , ' Predictors of poor function in RA based on two prospective UK inception cohorts. Do comorbidities matter? ' , Rheumatology . https://doi.org/10.1093/rheumatology/keab598
dc.identifier.issn1462-0324
dc.identifier.otherPURE: 25203030
dc.identifier.otherPURE UUID: 6589f282-73d2-4d50-927f-579f26d791c0
dc.identifier.otherScopus: 85128488965
dc.identifier.otherORCID: /0000-0002-0545-0276/work/133568267
dc.identifier.urihttp://hdl.handle.net/2299/25091
dc.description© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/)
dc.description.abstractObjectives. Evidence suggests that factors beyond disease activity associate with functional disability in RA. The primary study objective was to explore associations between comorbidities, sociodemographic factors and functional outcomes at five and 10 years.  Methods. RA patients from two UK prospective cohorts were grouped into low (<1.5) and high (1.5) five- and 10-year health assessment questionnaire (HAQ) score. Clinical variables (e.g. disease activity, rheumatoid nodules, erosions) and sociodemographic factors (e.g. ethnicity, deprivation) were recorded at baseline and yearly thereafter. Comorbidity was measured using the Rheumatic Diseases Comorbidity Index (RDCI). Binary logistic regression models were fitted using multiple imputation.  Results. In total, 2701 RA patients were recruited (mean age 56.1 years, 66.9% female). A total of 1718 (63.4%) had five-year and 820 (30.4%) 10-year follow-up data. In multivariable analysis, no association was found between RDCI and HAQ 1.5 at five or 10 years. Sociodemographic factors (increased age at disease onset, female gender, minority ethnicity) were associated with higher odds of HAQ 1.5 at five and 10 years, with worse deprivation additionally associated with HAQ 1.5 at 10 years (OR 0.79, 95% CI: 0.69, 0.90).  Conclusion. Comorbidities at baseline have not been found to be associated with worse RA functional outcome in the long-term. On the other hand, sociodemographic factors, independently of disease measures, are associated with worse functional outcome in RA at five and 10 years, in models adjusting for comorbidity burden. Tailoring management interventions according to not only clinical disease parameters but also patient sociodemographic factors may improve long-term outcomes including functional disability.en
dc.format.extent7
dc.language.isoeng
dc.relation.ispartofRheumatology
dc.subjectRheumatoid Arthritis
dc.subjectsocio-demographics
dc.subjectComorbidity
dc.subjectMultimorbidity
dc.subjecthealth assessment questionnaire
dc.titlePredictors of poor function in RA based on two prospective UK inception cohorts. Do comorbidities matter?en
dc.contributor.institutionCentre for Health Services and Clinical Research
dc.contributor.institutionHealth Research Methods Unit
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionDepartment of Psychology, Sport and Geography
dc.contributor.institutionDepartment of Clinical, Pharmaceutical and Biological Science
dc.contributor.institutionBasic and Clinical Science Unit
dc.description.statusPeer reviewed
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1093/rheumatology/keab598
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue


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