Andres Luque Ramos1,2, Imke Redeker3,4, Falk Hoffmann3,4, Johanna Callhoff3,4, Angela Zink3,4, Katinka Albrecht3,4. 1. From the Department for Health Services Research, Carl von Ossietzky University, Oldenburg; Epidemiology, German Rheumatism Research Centre, Berlin; Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany. andres.luque.ramos@uni-oldenburg.de. 2. A. Luque Ramos, MPH, Department for Health Services Research, Carl von Ossietzky University; I. Redeker, MSc, Epidemiology, German Rheumatism Research Centre; F. Hoffmann, Professor, Department for Health Services Research, Carl von Ossietzky University; J. Callhoff, MSc, Epidemiology, German Rheumatism Research Centre; A. Zink, Professor, Epidemiology, German Rheumatism Research Centre, and Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin; K. Albrecht, MD, Epidemiology, German Rheumatism Research Centre. andres.luque.ramos@uni-oldenburg.de. 3. From the Department for Health Services Research, Carl von Ossietzky University, Oldenburg; Epidemiology, German Rheumatism Research Centre, Berlin; Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Berlin, Germany. 4. A. Luque Ramos, MPH, Department for Health Services Research, Carl von Ossietzky University; I. Redeker, MSc, Epidemiology, German Rheumatism Research Centre; F. Hoffmann, Professor, Department for Health Services Research, Carl von Ossietzky University; J. Callhoff, MSc, Epidemiology, German Rheumatism Research Centre; A. Zink, Professor, Epidemiology, German Rheumatism Research Centre, and Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin; K. Albrecht, MD, Epidemiology, German Rheumatism Research Centre.
Abstract
OBJECTIVE: To investigate the prevalence of comorbidities in a population-based cohort of persons with rheumatoid arthritis (RA) compared to matched controls and to examine their association with patient-reported outcomes in a survey sample. METHODS: Data of 96,921 persons with RA [International Classification of Diseases, 10th ed (ICD-10) M05/M06] and 484,605 age- and sex-matched controls without RA of a German statutory health fund were studied regarding 26 selected comorbidities (ICD-10). A self-reported questionnaire, comprising joint counts [(tender joint count (TJC), swollen joint count (SJC)], functional status (Hannover Functional Ability Questionnaire), effect of the disease (Rheumatoid Arthritis Impact of Disease), and well-being (World Health Organization 5-item Well-Being Index; WHO-5) was sent to a random sample of 6193 persons with RA, of whom 3184 responded. For respondents who confirmed their RA (n = 2535), associations between comorbidities and patient-reported outcomes were analyzed by multivariable linear regression. RESULTS: Compared to controls, all investigated comorbidities were more frequent in persons with RA (mean age 63 yrs, 80% female). In addition to cardiovascular risk factors, the most common were osteoarthritis (44% vs 21%), depression (32% vs 20%), and osteoporosis (26% vs 9%). Among the survey respondents, 87% of those with 0-1 comorbidity but only 77% of those with ≥ 8 comorbidities were treated by rheumatologists. Increasing numbers of comorbidities were associated with poorer values for TJC, SJC, function, and WHO-5. CONCLUSION: Compared to a matched population, persons with RA present with increased prevalence of numerous comorbidities. Patients with RA and multimorbidity are at risk of insufficient rheumatological care and poorer patient-reported outcomes.
OBJECTIVE: To investigate the prevalence of comorbidities in a population-based cohort of persons with rheumatoid arthritis (RA) compared to matched controls and to examine their association with patient-reported outcomes in a survey sample. METHODS: Data of 96,921 persons with RA [International Classification of Diseases, 10th ed (ICD-10) M05/M06] and 484,605 age- and sex-matched controls without RA of a German statutory health fund were studied regarding 26 selected comorbidities (ICD-10). A self-reported questionnaire, comprising joint counts [(tender joint count (TJC), swollen joint count (SJC)], functional status (Hannover Functional Ability Questionnaire), effect of the disease (Rheumatoid Arthritis Impact of Disease), and well-being (World Health Organization 5-item Well-Being Index; WHO-5) was sent to a random sample of 6193 persons with RA, of whom 3184 responded. For respondents who confirmed their RA (n = 2535), associations between comorbidities and patient-reported outcomes were analyzed by multivariable linear regression. RESULTS: Compared to controls, all investigated comorbidities were more frequent in persons with RA (mean age 63 yrs, 80% female). In addition to cardiovascular risk factors, the most common were osteoarthritis (44% vs 21%), depression (32% vs 20%), and osteoporosis (26% vs 9%). Among the survey respondents, 87% of those with 0-1 comorbidity but only 77% of those with ≥ 8 comorbidities were treated by rheumatologists. Increasing numbers of comorbidities were associated with poorer values for TJC, SJC, function, and WHO-5. CONCLUSION: Compared to a matched population, persons with RA present with increased prevalence of numerous comorbidities. Patients with RA and multimorbidity are at risk of insufficient rheumatological care and poorer patient-reported outcomes.
Authors: Bryant R England; Huifeng Yun; Lang Chen; Jared Vanderbleek; Kaleb Michaud; Ted R Mikuls; Jeffrey R Curtis Journal: Arthritis Care Res (Hoboken) Date: 2021-08-02 Impact factor: 5.178