Prevalence and Physical and Mental Health Patterns of Rheumatic and Musculoskeletal Diseases in Portugal: Results from a National Health Survey

Jaime C Branco¹, Ana M. Rodrigues², Nelia Gouveia³, Leonor P Costa⁴, Monica Eusebio⁵, Sofia Ramiro^2,4,6, Pedro Machado^4,7,8, Filipa Mourão^4,9,10, Inês Silva^9,11, Pedro Laires⁴, Alexandre Sepriano^4,12, Filipe Araújo^4,13, Sónia Gonçalves⁴, Pedro S Coelho^4,14, Viviana Tavares⁴, Jorge Cerol^4,15, Jorge M Mendes^4,14, Loreto Carmona¹⁶ and Helena Canhao¹⁷, ¹NOVA Medical School/faculdade de ciências médicas, Universidade Nova de Lisboa, Lisboa, Portugal, ²CEDOC - Chronic Diseases FCM NOVA, NOVA Medical School - Faculdade de Ciências Médicas da UNL, Lisbon, Portugal, ³CEDOC - Chronic Diseases FCM NOVA, NOVA Medical School - Faculdade Ciências Médicas da UNL, Lisbon, Portugal, ⁴EpiReumaPt Study Group, Lisbon, Portugal, ⁵Portuguese Society of Rheumatology, Lisbon, Portugal, ⁶Rheumatology, Leiden University Medical Center, Leiden, Netherlands, ⁷Clínica Universitária de Reumatologia, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal, ⁸University College London - MRC Centre for Neuromuscular Diseases,, London, United Kingdom, ⁹Centro Hospitalar Lisboa Ocidental (CHLO- E.P.E.), Lisbon, Portugal, ¹⁰NOVA Medical School - Faculdade Ciências Médicas da Universidade Nova de Lisboa, Lisbon, Portugal, ¹¹EpiReumaPt Study Group, lisbon, Portugal, ¹²Rheumatology, Hospital de Egas Moniz - CHLO, Lisbon, Portugal, Lisbon, Portugal, ¹³Rheumatology, Centro Hospitalar de Lisboa Ocidental, Hospital Egas Moniz, Lisboa, Portugal, ¹⁴NOVA Information Management School, Lisbon, Portugal, ¹⁵Portuguese Catholic University, Lisbon, Portugal, ¹⁶Instituto de Salud Musculoesquelética, Madrid, Spain, ¹⁷Hospital Santa Maria - Serviço de Reumatologia, Lisboa, Portugal

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: cross-sectional studies, epidemiologic methods and rheumatic disease

Session Information

Date: Tuesday, November 10, 2015

Title: Epidemiology and Public Health Poster III (ACR): Gout and Non-Inflammatory Musculoskeletal Conditions

Session Type: ACR Poster Session C

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

Background/Purpose:

Rheumatic and musculoskeletal diseases (MSKD) are a
prevalent leading cause of disability and consume a large amount of
healthcare and social resources. MSKD have been associated with low levels of
physical and mental health in other countries. The purpose of this study
was to estimate the national
prevalence of hand, knee and hip osteoarthritis (OA), low back pain (LBP),
rheumatoid arthritis (RA), fibromyalgia (FM), gout, spondyloarthritis
(SpA), periarticular
disease (PD) systemic lupus erythematosus (SLE),
polymyalgia rheumatica (PMR) and osteoporosis (OP))
in the adult Portuguese population; to compare physical and mental health
between participants with and without MSKD. 

Methods:

EpiReumaPt is a national health survey conducted from Sep’2011 to Dec’2013, which
involved a three-stage approach. First, 10661 adult subjects were randomly
selected. Trained interviewers undertook structured face-to-face questionnaires
in participant’s households that included a screening for MSKD, and the EQ5D
and HAQ. Secondly, all participants screened positive for at least one MSKD
plus 20% of individuals with no rheumatic complaints were
invited to be seen by a rheumatologist at the local Primary Care Center
for a structured evaluation. Finally, a team of 3 experienced rheumatologists
revised all the clinical data and confirmed the diagnoses according to
previously validated criteria. Estimates were computed as weighted proportions,
in order to take into account the sampling design. 

Results:

Prevalence of MSKD in the adult Portuguese population
was as follows with 95% CI (table1): After adjustment, subjects with RMD had
significantly lower EQ5D scores (β=-0.09; p<0.001) and higher HAQ
scores (β=0.12; p<0.001) than subjects with no MSKD. Some MSKD
were significantly and independently associated with worse EQ5D scores: PMR (β=-0.334), RA (β=-0.132), FM (β=-0.100),
LBP (β=-0.07), Knee OA (β=-0.06) and PD (β=-0.04). Proportion
of anxiety and depression symptoms among the MSKD Portuguese patients was 16.7%
and 8.3%, respectively; the prevalence of anxiety symptoms was significantly
higher when compared with subjects without MSKD diseases (OR= 3.4; p=0.003).
Moreover, FM (OR=3.12; p<0.001), SpA (OR=2.82;
p=0.012) and LBP (OR=1.84; p=0.007) were significantly and independently
associated with the presence of anxiety symptoms; PMR (OR=18.81; p=0.006), FM
(OR=3.73; p=0.001) and LBP (OR=1.55; p=0.030) were significantly and
independently associated with the presence of depression symptoms. 

Total prevalence

(95% CI)

n=3877

LBP (n=1393)

26.41%

(23.32%; 29.51%)

(n=929)

15.76%

(13.47%; 18.04%)

Knee OA (n=981)

12.40%

(11.00%; 13.81%)

OP (n=858)

10.16%

(8.98%; 11.33%)

Hand OA (n=625)

8.73%

(7.53%; 9.93%)

Hip OA (n=199)

2.95%

(2.27%; 3.62%)

FM (n=149)

1.70%

(1.13%; 2.08%)

SpA(n=92)

1.63%

(1.19%; 2.08%)

Gout

(n=92)

1.28%

(0.96%; 1.60%)

(n=61)

0.73%

(0.52%; 0.95%)

SLE

(n=13)

0.15%

(0.06%; 0.25%)

PMR

(n=8)

0.10%

(0.02%; 0.18%)

Conclusion: MSKDs are highly prevalent in Portugal and are associated with
significant impairment of physical and mental health.

Disclosure: J. C. Branco, None; A. M. Rodrigues, None; N. Gouveia, None; L. P. Costa, None; M. Eusebio, None; S. Ramiro, None; P. Machado, None; F. Mourão, None; I. Silva, None; P. Laires, None; A. Sepriano, None; F. Araújo, None; S. Gonçalves, None; P. S Coelho, None; V. Tavares, None; J. Cerol, None; J. M. Mendes, None; L. Carmona, None; H. Canhao, None.

To cite this abstract in AMA style:

Branco JC, Rodrigues AM, Gouveia N, Costa LP, Eusebio M, Ramiro S, Machado P, Mourão F, Silva I, Laires P, Sepriano A, Araújo F, Gonçalves S, S Coelho P, Tavares V, Cerol J, Mendes JM, Carmona L, Canhao H. Prevalence and Physical and Mental Health Patterns of Rheumatic and Musculoskeletal Diseases in Portugal: Results from a National Health Survey [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/prevalence-and-physical-and-mental-health-patterns-of-rheumatic-and-musculoskeletal-diseases-in-portugal-results-from-a-national-health-survey/. Accessed .

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