ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 699

Improving Ankylosing Spondylitis Specific Outcomes at 6 Months Utilising a Novel Self-Management Education Program

Charles Inderjeeth1,2,3,4, Jean McQuade5, Warren Raymond6, Clara Connor7, Jack Edelman8, Nicola Cook9 and Kathy Briffa10, 1Rehabiltation and Aged care and Rheumatology, Sir Charles Gairdner Hospital and University of Western Australia, Nedlands, Australia, 2North Metropolitan Health Service, University of Western Australia, Perth, WA, Australia, 3Subiaco Rheumatology Clinic, Subiaco, Australia, 4Linear Clinical Research Ltd, Perth, Australia, 5Arthritis WA, Wembley, Australia, 6Rheumatology and Geriatric Medicine, Sir Charles Gairdner Hospital and University of Western Australia, Nedlands, Australia, 7Arthritis and Osteoporosis WA, Perth, Australia, 8Rheumatology, Sir Charles Gairdner Hospital, Perth, Australia, 9Royal Perth Hospital, Perth, Australia, 10School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: , , ,

Session Information

Date: Sunday, November 8, 2015

Title: Spondylarthropathies and Psoriatic Arthritis - Clinical Aspects and Treatment Poster I: Clinical Aspects and Assessments

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose : Disease specific self-management interventions are rare. After a needs assessment, focus group discussions, and Plan, Do, Study, Act (PDSA) model we developed and tested the Self Management for Ankylosing Spondylitis (SMAS) program, for people with Ankylosing Spondylitis (AS). We examined the benefits of an SMSA program for people with AS regarding change in health status, quality of life, and disease activity.

Methods: 134 people were recruited in this case cohort intervention. Exclusion criteria: <18yo; non-English speaking; co-morbid inflammatory musculoskeletal disease; and/or visual, auditory, or cognitive impairment. Participants attended a weekly 2.5 hour self-management education session facilitated by same two health professionals over 6 weeks. The scripted content included multidimensional strategies including stretches; and optional 7th week supervised exercise class.

Demographic, AS disease management characteristics, medication patterns, and outcomes were measured at baseline, 6 weeks, 3 and 6 months using repeated measures ANOVA for: back pain (VAS), fatigue (MAF), anxiety and depression (HAD), health distress (HDq), fatigue severity scale (FSS), pain self-efficacy (PSEQ), quality of life (SF-36) and Evaluating Ankylosing Spondylitis Qol (EASIQol), global perceived health (GPH), patients disease global assessment (PDGA). AS outcomes were analysed using repeated measures ANOVA for: Bath Ankylosing Spondylitis – Global, Disease Activity Index, and Functional Index (BAS-G, BASDAI, & BASFI), and Ankylosing Spondylitis QoL (ASQol).

Results: At baseline, 43.3% were male, and the mean age was 47.2 ± 15.1 years. The median time to AS diagnosis from the index symptom experience was 3 years with an IQR (1-6). The BAS-G improved between baseline and 3 months (p=0.011) and were sustained at 6 months (p=0.039). The BASDAI improved between baseline and 3 months (p=0.01) and were sustained at 6 months (p=0.009). The ASQol improved between baseline and 6 months (p=0.051). A positive trend were seen for the MAFs GFI, back pain (i.e. nocturnal and total), and the PDGA over the 6 months although these trends were not statistically significant. The composite SF-36 (physical and mental), HADs, HDq, FSS, composite Easiqol (physical, disease activity, wellbeing, and social), PSEQ demonstrated no improvement over the study. There was no significant change in medication usage over the 6 months.

Conclusion: SMAS for AS is independently effective in improving AS specific Disease activity, but global QOL scores did not change.

Table 1: Repeated Measures ANOVA for Quality of Life and Disease Activity tools over time.

Repeated Measures ANOVA

Baseline

WK6

WK6-BL

3MO

3M-BL

6MO

6MO-BL

Within-Subjects Contrasts

Mean (SE)

Mean (SE)

p-value

Mean (SE)

p-value

Mean (SE)

p-value

p-value

AS Specific Tools

BAS-G Score

6.09 (0.40)

5.83 (0.36)

0.548

4.89 (0.37)

0.011

5.03 (0.40)

0.039

0.004

BASDAI

5.30 (0.36)

4.83 (0.37)

0.107

4.36 (0.35)

0.01

4.30 (0.37)

0.009

0.005

AS Qol

8.83 (1.08)

8.17 (1.00)

0.409

7.50 (0.88)

0.104

7.03 (1.01)

0.051

0.059

BASFI

4.06 (0.40)

4.03 (0.34)

0.94

3.62 (0.31)

0.118

3.80 (0.40)

0.446

0.266

General Intervention Assessments

MAFs – GFI

26.14(2.33)

26.50 (2.43)

0.853

23.91 (2.67)

0.333

21.79 (2.67)

0.081

0.06

Back Pain Nocturnal

4.72 (0.41)

4.10 (0.41)

0.142

4.28 (0.42)

0.317

3.97 (0.43)

0.092

0.151

Back Pain Total

5.59 (0.45)

5.21 (0.38)

0.383

4.90 (0.36)

0.091

4.59 (0.46)

0.076

0.143

PDGA

5.24 (0.38)

5.07 (0.42)

0.634

4.66 (0.39)

0.176

4.55 (0.42)

0.081

0.246

SF 36 (Composite)

102.24 (2.07)

103.52 (1.74)

0.429

103.59 (1.59)

0.446

104.31 (1.76)

0.265

0.552

HADS

14.90 (1.62)

14.83 (1.64)

0.962

14.52 (1.43)

0.799

13.69 (1.54)

0.417

0.741

HDq

2.35 (0.25)

2.30 (0.27)

0.858

2.15 (0.26)

0.443

2.00 (0.26)

0.172

0.396

FSS

40.88 (1.87)

41.86 (1.69)

0.517

No Data

No Data

41.29 (1.93)

0.79

0.79

EasiQol (Composite)

35.78 (6.04)

36.11 (3.19)

0.950

30.44 (3.86)

0.228

30.33 (6.18)

0.492

0.544

PSEQ

36.62 (2.51)

36.31 (2.20)

0.861

36.66 (1.97)

.987

37.17 (2.59)

0.832

0.978

Disclosure: C. Inderjeeth, None; J. McQuade, None; W. Raymond, None; C. Connor, None; J. Edelman, None; N. Cook, None; K. Briffa, None.

To cite this abstract in AMA style:

Inderjeeth C, McQuade J, Raymond W, Connor C, Edelman J, Cook N, Briffa K. Improving Ankylosing Spondylitis Specific Outcomes at 6 Months Utilising a Novel Self-Management Education Program [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/improving-ankylosing-spondylitis-specific-outcomes-at-6-months-utilising-a-novel-self-management-education-program/. Accessed .

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