Background/Purpose: To identify patient characteristics and disease phenotypes associated with coping strategies in axial spondyloarthritis (axSpA), and assess whether coping strategies change over time.

Methods: Data from the Outcome in AS International Study (OASIS) were used. Coping was assessed using Coping with rheumatic stressors (CORS) at 4 and 6 years of follow-up. The CORS assesses coping with three stressors – pain, limitations, and dependence –, based on 61 items across eight strategies (score 1–4 for each strategy). Factors associated with each strategy were analysed with Generalized Estimation Equations (GEE). Age, sex and education were the main independent variables of interest. Variables with p 

Results: In total 116 patients [72% male, mean age 48 years (SD 12)] had CORS data at ≥1 timepoint. Patients made most use of comforting cognitions (mean: 3.0; (SD: 0.5)) to cope with pain, of pacing (2.4; (0.5)) to cope with limitations and of showing considerations (2.8; (0.5)) to cope with dependence (Tables 1–3). Several differences in preference for coping strategy were seen between patients but without clear patterns. Using the strategies that were most used per stressor as an example, it can be seen that using comforting cognitions to cope with pain was associated with lower (vs higher) education (β: -0.22; (95%CI: -0.41 to -0.03)) and with a higher BMI (0.01; (0.00 to 0.03) (Table 1). Pacing, to cope with limitations, was used more by older individuals (0.01; (0.01 to 0.02)) (Table 2). Showing considerations, to cope with dependence, was used less by those with more comorbidities (-0.10; (-0.19 to 0.00)) (Table 3). When adding axSpA health scores as additional variables to the initial models, coefficients remained largely unchanged across all strategies. As an example, the effect of adding health scores to the comforting cognitions model is shown in table 1 (2nd column). ASDAS, BASFI and MCS (SF-36) had no independent effect, were not effect modifiers and only had some confounding effect on the main relationships of interest. Finally, for the analyses of change over time, 102 patients had full CORS data on both timepoints. Analyses showed that coping strategies did not change over time (range βtime: -0.04 to 0.07/year).

Conclusion: Coping strategies in axSpA appear more strongly influenced by patient characteristics, to a lesser extent disease phenotypes but not by axSpA related health scores. Furthermore, no change over time was found supporting that coping is a trait and more dependent on the person than the disease.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/coping-with-rheumatic-stressors-in-axial-spondyloarthritis-association-with-patient-characteristics-and-disease-phenotypes-and-changes-over-time/