| 1. |
- Bergsten, Ulrika, et al.
(författare)
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Patterns of background factors related to early RA patients' conceptions of the causes of their disease
- 2011
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Ingår i: Clinical Rheumatology. - London : Springer Science and Business Media LLC. - 0770-3198 .- 1434-9949. ; 30:3, s. 347-352
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present study was to identify patterns of background factors related to the early RA patients' conceptions of the cause of the disease. Conceptions from a qualitative study formed the basis for the stratification of 785 patients from the Swedish EIRA study answering a question about their own thoughts about the cause to RA. Logistic regression analyses were used to explore the associations between patients' conceptions and relevant background factors: sex, age, civil status, educational level, anti-cyclic citrullinated peptide antibody (anti-CCP) and smoking habits. The results were presented as odds ratios (OR) with 95% confidence intervals (CI). A conception of family-related strain was strongly associated with being young (OR 0.50; 95% CI 0.33-0.78 for age 58-70 vs. 17-46), female (OR 0.38; 95% CI 0.25-0.60 for male vs. female) and having a high level of education (OR 2.15; 95% CI 1.54-3.01 for university degree vs. no degree). A conception of being exposed to climate changes was associated with being male (OR 1.99; 95% CI 1.24-3.22 for male vs. female), having a low level of education (OR 0.33; 95% CI 0.18-0.58 for university degree vs. no degree) and positive Anti-CCP (OR 1.72; 95% CI 1.03-2.87 for positive vs. negative Anti-CCP). Linking patients' conceptions of the cause of their RA to background factors potentially could create new opportunities for understanding the complexity of the aetiology in RA. Furthermore, this information is important and relevant in the care of patients with early RA.
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| 2. |
- Bremander, Ann, et al.
(författare)
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Depression and age as predictors of patient-reported outcome in a multidisciplinary rehabilitation programme for chronic musculoskeletal pain.
- 2011
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Ingår i: Musculoskeletal Care. - : Wiley. - 1557-0681 .- 1478-2189. ; 9:1, s. 8-41
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Tidskriftsartikel (refereegranskat)abstract
- Background. The recommended treatment for chronic musculoskeletal pain is multidisciplinary, with a cognitive approach. The aim of this study was to investigate health-related quality of life (HRQoL) outcome after a multidisciplinary treatment with a cognitive approach. Methods. A total of 131 subjects who participated in a multidisciplinary rehabilitation programme (2005-2008) were studied at baseline and after six months, using the Short Form Short Form 36-item Health Survey questionnaire (SF-36) as primary outcome (HRQoL), and the Hospital Anxiety and Depression Scale (HAD) and pain as secondary outcomes and possible baseline predictors for HRQoL. Results. Complete data were available for 97 subjects (85 women, mean age [SD] 44.6 [9.7] years). The SF-36 subscales physical function (PF), general health (GH), vitality (VT), social function (SF) and mental health (MH), the visual analogue scale for pain and the HAD improved significantly (p < 0.05) at follow-up compared with baseline. A pre-treatment probable depression (HAD score ≥11) was associated with a favourable outcome of the SF-36 subscales PF (odds ratio [OR] 5.6; p = 0.01), VT (OR 4.3; p = 0.02) and MH (OR 3.6; p = 0.02). A probable anxiety (HAD score ≥11) was associated with a favourable outcome of PF (OR 2.6; p = 0.05). There was an even stronger association for younger subjects (20-45 years), with probable depression scores at baseline and a favourable HRQoL outcome at follow up. Conclusion. This multidisciplinary rehabilitation programme, using a non-pharmacological cognitive approach, seemed to yield a better outcome concerning HRQoL measures in younger subjects with higher depression scores at baseline. This information is important for clinics when tailoring a multidisciplinary rehabilitation programme for patients with musculoskeletal chronic pain. Copyright © 2010 John Wiley & Sons, Ltd.
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| 3. |
- Bremander, Ann, 1957-, et al.
(författare)
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Population-based estimates of common comorbidities and cardiovascular disease in ankylosing spondylitis
- 2011
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Ingår i: Arthritis care & research. - Hoboken, NJ : John Wiley & Sons. - 2151-464X .- 2151-4658. ; 63:4, s. 550-556
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To study the rate of common comorbidities and cardiovascular disease in patients with ankylosing spondylitis (AS) compared with the general population seeking health care.METHODS: This cohort study included 935 subjects (67% men) ages ≥20 years diagnosed with AS and the adult background population in Southern Sweden. During 2004 to 2007 we recorded the occurrence of physicians' diagnostic codes for a select number of comorbidities commonly associated with AS and cardiovascular disease and risk factors. We obtained standardized morbidity-rate ratios (SMRs) by dividing the observed morbidity rate in AS patients by the expected rate based on the corresponding rate of the disease in the general population of the county seeking health care.RESULTS: The highest SMRs were found for uveitis (34.35, 95% confidence interval [95% CI] 28.55-40.98) and inflammatory bowel disease (9.28, 95% CI 7.07-11.97). Also, we found increased SMRs for ischemic heart diseases (2.20, 95% CI 1.77-2.70), hypertension (1.98, 95% CI 1.72-2.28), and diabetes mellitus (1.41, 95% CI 1.10-1.78). Furthermore, the SMRs for psoriasis, osteoporosis, and atrioventricular blocks were also statistically significantly elevated.CONCLUSION: Inflammatory diseases affecting the eye and the digestive system were the most notable comorbidities in AS patients, but the rate for cardiovascular disease was also high. Using comprehensive longitudinal population-based register data is a promising tool to evaluate the excess consultation rate and total burden of rheumatic disease on patients and society. Copyright © 2011 by the American College of Rheumatology.
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| 4. |
- Haglund, Emma, et al.
(författare)
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Prevalence of spondyloarthritis and its subtypes in southern Sweden
- 2011
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ. - 1468-2060 .- 0003-4967. ; 70, s. 943-948
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate the prevalence of spondyloarthritis and its subtypes. METHODS: The Swedish healthcare organisation comprises a system where all inpatient and outpatient care is registered by a personal identifier. For the calendar years 2003-7, all residents aged ≥15 years in the southernmost county of Sweden (1.2 million inhabitants) diagnosed by a physician with spondyloarthritis (ankylosing spondylitis (AS), psoriatic arthritis (PsA), inflammatory arthritis associated with inflammatory bowel disease (Aa-IBD) or undifferentiated spondylarthritis (USpA)) were identified. To obtain valid point estimates of prevalence by the end of 2007, identification numbers were cross-referenced with the population register to exclude patients who had died or relocated. RESULTS: The authors estimated the prevalence of spondyloarthritis (not including chronic reactive arthritis) as 0.45% (95% CI 0.44% to 0.47%). The mean (SD) age of patients with prevalent spondyloarthritis by the end of 2007 was 53 (15) years. Among the component subtypes, PsA accounted for 54% of cases, AS 21.4%, USpA 17.8% and Aa-IBD 2.3% with a prevalence of 0.25%, 0.12%, 0.10% and 0.015%, respectively. The remaining 6.4% had some form of combination of spondyloarthritis diagnoses. The prevalence of spondyloarthritis at large was about the same in men and women. However, the subtype PsA was more prevalent in women and AS was more prevalent in men. CONCLUSION: In Sweden the prevalence of spondyloarthritis leading to a doctor consultation is not much lower than rheumatoid arthritis. PsA was the most frequent subtype followed by AS and USpA, and the two most frequent subtypes PsA and AS also display some distinct sex patterns.
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| 5. |
- Soderlin, M. K., et al.
(författare)
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Smoking at onset of rheumatoid arthritis (RA) and its effect on disease activity and functional status: experiences from BARFOT, a long-term observational study on early RA
- 2011
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Ingår i: Scandinavian Journal of Rheumatology. - Abingdon : Informa UK Limited. - 1502-7732 .- 0300-9742. ; 40:4, s. 249-255
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To assess the effects of smoking on disease outcome in a large cohort of patients with early rheumatoid arthritis (RA). Methods: Between 1996 and 2004, 1787 adult patients (disease duration <= 1 year) were included in the BARFOT early RA study in Sweden. Smoking status was recorded at inclusion in the study. Disease Activity Score using 28 joint counts (DAS28), C-reactive protein (CRP), Health Assessment Questionnaire (HAQ) score, rheumatoid factor (RF), antibodies to cyclic citrullinated peptide (anti-CCP), general health (GH) and pain visual analogue scales (VAS), and drug treatment were registered at inclusion and at follow-up at 3, 6, and 12 months. European League Against Rheumatism (EULAR) response and remission criteria were applied at 3, 6, and 12 months. Results: The proportion of patients who smoked at inclusion in the study fell from 29% in 1996 to 20% in 2004. There were no significant differences in disease activity at inclusion stratified according to smoking status. At 12 months of follow-up, 18% of current smokers at inclusion, 12% of previous smokers, and 11% of never smokers had high disease activity (DAS28 > 5.1, p = 0.005). Significantly fewer current smokers were in remission at 12 months (33%) compared to never smokers (36%) and previous smokers (42%) (p = 0.013). Current smoking at inclusion independently predicted poor EULAR response up to 12 months of follow-up. Conclusion: The present study gives some support to earlier data indicating that RA patients who smoke have a more active disease but further studies are needed to confirm this.
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