| 1. |
- 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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| 2. |
- Hagel, Sofia, et al.
(författare)
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Trends in the first decade of 21st century healthcare utilisation in a rheumatoid arthritis cohort compared with the general population.
- 2013
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Ingår i: Annals of the Rheumatic Diseases. - London : BMJ. - 1468-2060 .- 0003-4967. ; 72:7, s. 1212-1216
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To study 21st century trends in healthcare utilisation by patients with rheumatoid arthritis (RA) compared with the general population. METHODS: Observational cohort study. Using Swedish healthcare register data, we identified 3977 Region Skåne residents (mean age in 2001, 62.7 years; 73% women) presenting with RA (International Classification of Diseases-10 codes M05 or M06) in 1998-2001. We randomly sampled two referents from the general population per RA patient matched for age, sex and area of residence. We calculated the year 2001-2010 trends for the annual ratio (RA cohort/referents) of the mean number of hospitalisations and outpatient clinic visits. RESULTS: By the end of the 10-year period, 62% of patients and 74% of referents were still alive and resident in the region. From 2001 to 2010, the ratio (RA cohort/referents) of the mean number of hospitalisations for men and women decreased by 27% (p=0.01) and 28% (p=0.004), respectively. The corresponding decrease was 29% (p=0.005) and 16% (p=0.004) for outpatient physician care, 34% (p=0.009) and 18% (p=0.01) for nurse visits, and 34% (p=0.01) and 28% (p=0.004) for physiotherapy. The absolute reduction in number of hospitalisations was from an annual mean of 0.79 to 0.69 in male patients and from 0.71 to 0.59 in female patients. The corresponding annual mean number of consultations in outpatient physician care by male and female RA patients changed from 9.2 to 7.7 and from 9.9 to 8.7, respectively. CONCLUSIONS: During the first decade of the 21st century, coinciding with increasing use of earlier and more active RA treatment including biological treatment, overall inpatient and outpatient healthcare utilisation by a cohort of patients with RA decreased relative to the general population.
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| 3. |
- 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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| 4. |
- Meesters, Jorit, et al.
(författare)
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The risk for depression in patients with ankylosing spondylitis : a population-based cohort study
- 2014
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Ingår i: Arthritis Research & Therapy. - London : BioMed Central. - 1478-6362. ; 16:5
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Depression is frequent in ankylosing spondylitis (AS) patients. However, epidemiological data about the potential increase in risk are lacking. This study compares the rate of doctor-diagnosed depression in a well defined cohort of AS patients to the general population seeking care.Methods: The Skåne Healthcare Register comprises healthcare data of each resident in Region Skåne, Sweden (population 1.2 million), including ICD-10 diagnoses. Using physician coded consultation data from years 1999 to 2011, we calculated depression consultation rates for all AS patients. We obtained standardized depression-rate ratios by dividing the observed depression rate in AS patients by the expected rate based on the corresponding age- and sex-specific rates of depression in the general population seeking care. A ratio >1 equals a higher rate of depression among AS patients.Results: The AS cohort consisted of 1738 subjects (65% men) with a mean age of 54 years. The reference population consisted of 967,012 subjects. During the 13-year observation period 10% (n = 172) of the AS cohort had a doctor-diagnosed depression compared to 6% (n = 105) to be expected. The standardized estimate of depression-rate ratio was 1.81 (95% confidence interval 1.44 to 2.24) in women men and 1.49 (1.20 to 1.89) in men.Conclusions: The rate of doctor-diagnosed depression is increased about 80% in female and 50% in male AS patients. Future challenges are to timely identify and treat the AS patients who suffer from depression. © 2014 Meesters et al.; licensee BioMed Central Ltd.
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| 5. |
- Roos, Ewa, et al.
(författare)
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Change in self-reported outcomes and objective physical function over 7 years in middle-aged subjects with or at high risk of knee osteoarthritis
- 2008
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Ingår i: Annals of the Rheumatic Diseases. - : BMJ. - 1468-2060 .- 0003-4967. ; 67:4, s. 505-510
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Describe the clinical course and predictors of change in self-reported outcomes and objectively assessed physical function over time in middle-aged subjects at high risk of, or with knee osteoarthritis (OA). METHODS: We examined 259 subjects (mean age 52.6 [SD 10.4]) at mean 18 and 25 years after previous meniscectomy and 50 population-based age- and sex-matched reference subjects with the Knee injury and Osteoarthritis Outcome Score (KOOS), one-leg hop for distance and number of knee-bendings in 30 seconds. Radiographic OA was defined as equivalent to Kellgren & Lawrence grade 2 or worse. RESULTS: At first assessment, meniscectomized subjects reported worse pain, function and quality of life compared with the reference group (p<0.001). They also performed fewer knee-bendings per 30 sec (27 vs. 31, p=0.02). The meniscectomized patients worsened over the 4 to 10 year observation time in all measured outcomes (p<0.001), and to a greater extent than the reference group in pain (-5, 95% CI -10,0) and one-leg hop (-11, 95% CI -18,-3). Being a woman, or having radiographic knee OA, enhanced the worsening in both self-reported and objectively assessed outcomes. Older age and a higher BMI influenced objectively assessed physical function, but not self-reported outcomes. CONCLUSION: Worsening over time in knee-related pain and function is greater in meniscectomized subjects compared with reference subjects. Rehabilitative efforts may be warranted in middle-aged meniscectomized patients, especially in women and those who have developed radiographic knee OA, who are at greater risk of worsening.
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| 6. |
- Strömbeck, Britta, et al.
(författare)
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Cost of Illness from the Public Payers' Perspective in Patients with Ankylosing Spondylitis in Rheumatological Care.
- 2010
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Ingår i: Journal of Rheumatology. - : The Journal of Rheumatology. - 0315-162X .- 1499-2752. ; 37, s. 2348-2355
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To estimate the incremental costs to public payers for patients with ankylosing spondylitis (AS) of working age compared with reference subjects from the general population. METHODS: We investigated total costs for 3 years (2005-2007) in 116 outpatients under 66 years of age with AS attending rheumatological care in Malmö, Sweden. Mean (SD) age was 46 (11) years and mean (SD) disease duration was 24 (11) years. Two subjects perAS patient matched for age, sex, and residential area were selected from the Population Register to serve as a reference group. We retrieved data concerning sick leave, prescription drugs, and healthcare consumption from Swedish health-cost registers by the unique personal identification numbers. RESULTS: The mean total cost for the 3-year period 2005-2007 was US $37,095 (SD $30,091) for patients with AS, and $11,071 (SD $22,340) for the reference group. The mean indirect cost was $19,618 and $5905, respectively. Mean cost for healthcare was $8998 for the AS patients and $4187 for the reference subjects, and mean cost for drugs was $8479 and $979, respectively. The patients with AS treated with biological therapy constituted 80% of the total drug cost, but just 40% of the cost for disability pension. CONCLUSION: Patients with AS had 3-fold increase in costs compared to reference subjects from the general population, and the drug costs were almost 10 times as high. Production losses (indirect cost) represented more than half of total cost (53%).
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| 7. |
- Strömbeck, Britta, et al.
(författare)
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Patients with ankylosing spondylitis have increased sick leave—a registry-based case-control study over 7 yrs
- 2009
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Ingår i: Rheumatology. - Oxford : Oxford University Press. - 1462-0324 .- 1462-0332. ; 48:3, s. 289-292
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Using prospectively collected registry data to investigate sick leave (sickness benefit and sickness compensation) over a 7-yr period in patients with AS in comparison with population-based controls matched for age, sex and residential area.METHODS: We investigated 122 (21 women and 101 men) outpatients with AS in South Sweden, born 1942 or later, from rheumatology specialist care for their sick leave during a 7-yr period. Mean (S.D.) age was 43 (11) yrs and mean (S.D.) disease duration was 20 (11) yrs. Two controls per case, matched for age, sex and residential area were selected from the Swedish National Population Register. Data concerning sick leave for cases and controls, based on the subjects' unique 10-digit personal identification number, were retrieved from the national register of the Swedish Social Insurance Agency.RESULTS: More AS patients than controls were registered for sickness benefit (52 vs 36%, P < 0.01) and sickness compensation (42 vs 11%, P < 0.001). Cases had an increased risk for sick leave compared with controls with a relative risk of 1.8; 95% CI 1.5, 2.1; and cases had more days with sick leave than controls (median number of more days per year 30; 95% CI 2, 72).CONCLUSIONS: Using the Swedish Social Insurance Agency's registers for sick leave, we found that patients with AS in rheumatology specialist care in South Sweden have an increased level of sick leave compared with controls. These population-based registers have a great potential for studies of the effects of different interventions on sick leave. © 2009 The Author(s).
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