Higher Education Is Associated with a Better Rheumatoid Arthritis Outcome Concerning Pain and Function but Not Disease Activity: Results from Swedish Registers

Xia Jiang¹, Maria Sandberg², Saedis Saevarsdottir³, Lars Alfredsson⁴, Lars Klareskog⁵ and Camilla Bengtsson⁶, ¹Karolinska Institutet, Stockholm, Sweden, ²Unit of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Karolinska Institutet, Stockholm, Sweden, ³Rheumatology Unit, Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden, ⁴Unit of Cardiovascular Epidemiology, Institute of Enviornmental Medicine, Karolinska Institutet, Karolinska Institutet, Stockholm, Sweden, ⁵Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden, ⁶The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Education, medication, outcome measures and rheumatoid arthritis (RA)

Session Information

Date: Monday, November 9, 2015

Title: Epidemiology and Public Health Poster II: Pathogenesis and Treatment of Systemic Inflammatory Diseases

Session Type: ACR Poster Session B

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

Background/Purpose:

To investigate the influence of education (achieving university/college degree (high) or not (low)) on the outcomes of early RA, in terms of disease activity, pain, and functional impairment.

Methods:

We used DMARD-naïve RA patients recruited in the Epidemiological Investigation of RA (EIRA) study with outcomes followed in the Swedish Rheumatology Quality (SRQ) register (N=3021). Outcomes were categorized in three ways: 1) scores equal to/above median vs. below median; 2) DAS28-based low disease activity, good response, remission; 3) scores decreased over the median vs. less than median. Associations between education and outcomes were calculated by Poisson regressions, at diagnosis and at each of the three (3, 6, 12 months) follow-up visits.

Results:

High and low educated patients had similar symptom durations (195 days) and anti-rheumatic therapies at baseline, and comparable treatment patterns during follow-up. Higher educated patients had less pain, less functional disability at baseline and throughout the whole follow-up period (VAS-pain: baseline: 49 (28-67) vs. 53 (33-71), p<0.0001; 1-year-visit: RR=0.81 (95% CI 0.73-0.90). HAQ: baseline: 0.88 (0.50-1.38) vs. 1.00 (0.63-1.50), p=0.001; 1-year-visit: 0.84 (0.77-0.92)). They also had greater chances to achieve pain remission (VAS-pain≤20) after one year (1.17 (1.07-1.28)). Adjustments for smoking and BMI altered the results only marginally. Education did not influence DAS28-based outcomes.

Conclusion:

In Sweden, with tax-financed, general health-care system, higher educated RA patients experienced less pain, less functional disability, and achieved pain remission more often during the first year receiving standard care. Education affected neither time to referral to rheumatologists nor anti-rheumatic treatments.

Disclosure: X. Jiang, None; M. Sandberg, None; S. Saevarsdottir, None; L. Alfredsson, None; L. Klareskog, None; C. Bengtsson, None.

To cite this abstract in AMA style:

Jiang X, Sandberg M, Saevarsdottir S, Alfredsson L, Klareskog L, Bengtsson C. Higher Education Is Associated with a Better Rheumatoid Arthritis Outcome Concerning Pain and Function but Not Disease Activity: Results from Swedish Registers [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/higher-education-is-associated-with-a-better-rheumatoid-arthritis-outcome-concerning-pain-and-function-but-not-disease-activity-results-from-swedish-registers/. Accessed .

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