Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Knowledge about the impact of illness perceptions on health-related quality of life (HRQoL) in patients with axial Spondyloarthritis (axSpA) and other forms of chronic back pain (CBP) is lacking. The aim is to explore the association between illness perceptions and HRQoL in patients with short symptom duration of axSpA and other forms of CBP at baseline.
Methods: The SPACE study includes patients with CBP (≥3 months, ≤2 years, onset <45 years) from 5 European centers. Revised Illness Perception Questionnaire (IPQ-R) was completed at baseline. In illness identity dimension, patients reported if they have experienced and believed that a certain symptom is CBP related. Other IPQ-R dimensions used 5-point Likert scales (1 strongly disagree, 5 strongly agree). HRQoL was assessed by 36-item Short-Form (SF-36). Physical (PCS) and Mental Component Summary (MCS) scores were calculated ranging from 0 (worst) to 100 (best). Univariable regression models were built for each IPQ-R subscale as independent and PCS or MCS as dependent variable. The models were adjusted for age and gender and stratified in case of effect modification by gender (p<0.20).
Results: 450 patients were included; 176 fulfilled the axSpA ASAS criteria. Mean PCS was 28.3 (SD 16.1) for axSpA patients and 25.4 (SD 14.8) for CBP. As the MCS was only slightly decreased compared to the general population of 50 (SD 10) (48.8 (SD 13.7) axSpA and 48.3 (SD 12.1) CBP patients), analyses focused on PCS. Patients reported a mean of 4.3 (axSpA) and 4.5 (CBP) symptoms to be associated with back pain. Most reported symptoms were pain and joint stiffness. All other dimensions showed a mean of approximately 3, except psychological attributions, risk factors, immunity, and accident (mean approximately 2). All patients attributed their complaints mostly to genetic factors. In both patient groups attribution of multiple symptoms to CBP (Table 1; β=-1.9 axSpA, β=-2.0 CBP) was associated with lower PCS. Stronger belief in severe consequences in male axSpA patients (β=-11.3) and stronger belief in risk factors (β=-6.9) or immunity (β=-8.3) as a cause in male CBP patients were associated with lower PCS. Whereas, in male axSpA patients, being better in understanding their complaints (β=6.2) was associated with higher PCS. In female axSpA patients stronger belief in severe consequences (β=-7.3) and in female CBP patients more negative emotions towards their complaints (β=-3.8) and being better in understanding their complaints (β=3.3) were statistically significant. No gender differences were found for emotional representation (β=-5.0), psychological attributions (β=-3.4), immunity (β=-4.0), or accident (β=-3.0) in axSpA and consequences (β=-8.5) or chance (β=-2.0) in CBP patients.
Conclusion: Negative illness perceptions are associated with lower PCS of HRQoL in patients with axSpA and other forms of CBP.
To cite this abstract in AMA style:van Lunteren M, Bakker P, Scharloo M, Kaptein A, Ez-Zaitouni Z, Fongen C, Landewé R, van Oosterhout M, Lorenzin M, van der Heijde D, van Gaalen F. Illness Perceptions and Health-Related Quality of Life in Patients with Axial Spondyloarthritis and Other Forms of Chronic Back Pain in the Spondyloarthritis Caught Early (SPACE)-Cohort [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/illness-perceptions-and-health-related-quality-of-life-in-patients-with-axial-spondyloarthritis-and-other-forms-of-chronic-back-pain-in-the-spondyloarthritis-caught-early-space-cohort/. Accessed April 23, 2019.
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