Please use this identifier to cite or link to this item:
https://hdl.handle.net/2440/139200
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Type: | Journal article |
Title: | Trajectories of self-reported pain-related health outcomes and longitudinal effects on medication use in rheumatoid arthritis: a prospective cohort analysis using the Australian Rheumatology Association Database (ARAD) |
Author: | Pisaniello, H.L. Lester, S. Russell, O. Black, R. Tieu, J. Richards, B. Barrett, C. Lassere, M. March, L. Buchbinder, R. Whittle, S.L. Hill, C.L. |
Citation: | RMD Open, 2023; 9(3):e002962-e002962 |
Publisher: | BMJ |
Issue Date: | 2023 |
ISSN: | 2056-5933 2056-5933 |
Statement of Responsibility: | Huai Leng Pisaniello, Susan Lester, Oscar Russell, Rachel Black, Joanna Tieu, Bethan Richards, Claire Barrett, Marissa Lassere, Lyn March, Rachelle Buchbinder, Samuel L Whittle, Catherine L Hill |
Abstract: | Objective To determine distinct trajectories of self-reported pain-related health status in rheumatoid arthritis (RA), their relationship with sociodemographic factors and medication use. Methods 988 Australian Rheumatology Association Database participants with RA (71% female, mean age 54 years, mean disease duration 2.3 years) were included. Distinct multi-trajectories over 15-year follow-up for five different self-reported pain-related health outcome measures (Health Assessment Questionnaire Disability Index, visual analogue scores for pain, arthritis, global health and the Assessment of Quality of Life utility index) were identified using latent variable discrete mixture modelling. Random effects models were used to determine associations with medication use and biologic therapy modification during follow-up. Results Four, approximately equally sized, pain/health status groups were identified, ranging from ‘better’ to ‘poorer’, within which changes over time were relatively small. Important determinants of those with poorer pain/ health status included female gender, obesity, smoking, socioeconomic indicators and comorbidities. While biologic therapy use was similar between groups during follow-up, biologic therapy modifications (plinear<0.001) and greater tendency of non-tumour necrosis factor inhibitor use (plinear<0.001) were observed in those with poorer pain/health status. Similarly, greater use of opioids, prednisolone and non-steroidal anti-inflammatory drugs was seen in those with poorer pain/health status. Conclusion In the absence of disease activity information, distinct trajectories of varying pain/health status were seen from the outset and throughout the disease course in this RA cohort. More biologic therapy modifications and greater use in anti-inflammatories, opioids and prednisolone were seen in those with poorer pain/health status, reflecting undesirable lived experience of persistent pain in RA. |
Keywords: | Humans Arthritis, Rheumatoid Pain Prednisolone Analgesics, Opioid Antirheumatic Agents Cohort Studies Prospective Studies Rheumatology Quality of Life Middle Aged Australia Female Male Self Report Outcome Assessment, Health Care |
Rights: | © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. |
DOI: | 10.1136/rmdopen-2022-002962 |
Grant ID: | http://purl.org/au-research/grants/nhmrc/384330 http://purl.org/au-research/grants/nhmrc/1194483 |
Published version: | http://dx.doi.org/10.1136/rmdopen-2022-002962 |
Appears in Collections: | Medicine publications |
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