Background/Purpose: RA is a systemic disease that can compromise many aspects of patient health. The increased psychological burden of RA is known and multifactorial, recent studies reported specific beliefs and fears that can be measured. The Fear Assessment in Inflammatory Rheumatic diseases (FAIR) questionnaire was developed to assess fears in RA and SpA, based on previous studies on the perspectives and fears of French patients with these diseases. The aim of this study was to evaluate the performance of FAIR questionnaire in a cohort of patients with RA residing in Argentina and to establish associations between the score, and sociodemographic and disease characteristics.

Methods: Multicenter, cross-sectional and analytical study. Patients ≥18 years old with diagnosis of RA (2010 ACR-EULAR criteria) were included. Sociodemographic, and disease characteristics, disease activity, functional status, quality of life, treatment, proximity to the disease (defined as past or current contact with a relative, friend or partner with RA) and educational exposure about RA were recorded. Translation and cross-cultural adaptation of the FAIR was carried out according to international standards. All patients completed the adapted FAIR Argentinian version (FAIR-A), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Statistical analysis: Descriptive statistics. Cronbach’s alpha and test-retest reproducibility were determined. Association between FAIR-A score, and sociodemographic and disease characteristics was analyzed. A multiple linear regression model was applied.

Results: Two hundred and ten patients were included. Approximately 85% were women with a mean age of 54.5 ± 12.4 years, 59% had health insurance and 28% lived alone. Median disease duration was 96 months (IQR 48-144), 91.9% were seropositive for rheumatoid factor, 65.2% had erosive disease, and 33.8% extra-articular manifestations. Median DAS28 was 3.3 (IQR 2.4-4.6), HAQ-A 1 (IQR 0.5-1.6) and RA-QoL II 6.3 (IQR 5.0-7.6). Ninety eight percent of the patients received DMARDs, 45.2% NSAIDs, 35.2% systemic corticosteroids (CS). Median FAIR-A score was 61.5 (IQR 36-83), internal consistency was excellent (Cronbach’s alpha= 0.92), with no floor or ceiling effect on the total score. There were no redundant questions and the reproducibility was 0.69. There was a moderate correlation with the GAD-7 (r= 0.55) and PHQ-9 (r= 0.50). A higher FAIR-A score was associated with self-injurious thoughts (p< 0.0001), NSAIDs and CS use (p= 0.002 and p= 0.03, respectively), and living alone (p= 0.01). The Main determinants of FAIR-A on multiple regression were higher anxiety level (Beta= 8.33), higher depression level (Beta= 3.52) and younger age (Beta= 2.25).

Conclusion: The performance of the FAIR-A questionnaire was acceptable with excellent internal consistency, good reproducibility, and moderate correlation with the other psychometric measures. Therefore, it proves to be a valid tool to assess fears in RA.

« Back to ACR Convergence 2022

ACR Meeting Abstracts - https://acrabstracts.org/abstract/performance-of-fear-assessment-in-inflammatory-rheumatic-diseases-fair-questionnaire-in-a-cohort-of-rheumatoid-arthritis-patients-in-argentina/