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Abstract Number: 2083

Predictors of Health Perceptions Among Women with Lupus

Patricia P. Katz1, Eliza Chakravarty2, Robert S. Katz3 and Kaleb Michaud4, 1Medicine/Rheumatology, University of California San Francisco, San Francisco, CA, 2Arthritis and Clinical Immunology, Oklahoma Medical Research Foundation, Oklahoma City, OK, 3Rush University Medical Center, Chicago, IL, 4Internal Medicine, University of Nebraska Medical Center, Omaha, NE

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: health status and socioeconomic factors, Lupus

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Session Information

Date: Monday, November 9, 2015

Session Title: ARHP II: Lupus

Session Type: ARHP Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Health perceptions, such as self-rated health, have been shown to predict multiple adverse health outcomes and to have a strong socioeconomic status (SES) gradient.  Although SES-related health disparities have been found in lupus, previous studies have not examined the role of SES in health perceptions in lupus, independent of other health factors. 

Methods: Data were from the National Data Bank for Rheumatic Diseases (NDB), for which participants complete questionnaires every 6 months.  We included in analyses only women with lupus who responded to at least one questionnaire in 2014 (n = 481).  Health perceptions were measured with 3 items:  (1) health status numeric rating scale ranging from 0 (dead) to 100 (perfect health); (2) health satisfaction (“how satisfied are you with your health?”); responses ranged from very unsatisfied to very satisfied; and (3) overall health rating (excellent, good, fair, poor).  The latter two items were dichotomized for analysis (satisfied or very satisfied vs. other; excellent or good vs. fair or poor).  Potential predictors of health perceptions included SES (age, education, Medicaid or no health insurance vs other), lupus status (duration, disease activity measured with the Systemic Lupus Activity Questionnaire [SLAQ]), disease damage measured with the Brief Inventory of Lupus Damage [BILD]), and symptoms and other health factors (obesity, pain, physical function, fatigue, comorbidities, depressive symptoms, sleep, and smoking).  Multiple linear and logistic regression analyses were conducted to identify independent predictors of health perceptions.

Results: Sample characteristics are shown in Table 1.  In models including only age and SES variables, only low education was associated with health perceptions (Table 2).  After adding lupus status, symptoms, and other health factors, SES variables were no longer associated with health perceptions.  Four variables were consistently associated with each health rating:  pain rating, physical function, disease activity, and smoking.

Conclusion:  Health perceptions in lupus were primarily driven by health-related variables rather than SES.  It is possible, however, that the effects of SES may be indirect; for example, smoking rates are higher among individuals with lower education.  Additional study is needed to identify the ability of health perceptions s to predict health outcomes in lupus.

 

Table 1.  Characteristics of sample

 

SES variables

 

 

 

Age, mean ± SD

57.9 ± 13.0

Education ≤ 12 years

22.1%

White

 

79.4%

Medicaid or no health insurance

13.5%

Lupus status

 

 

 

Duration

21.0 ± 12.1

Disease damage (BILD)

3.3 ± 2.0

Disease activity (SLAQ)

 

11.0 ± 7.1

 

 

Symptoms, other health factors

 

 

Pain rating1

4.3 ± 3.0

Rheumatic Disease Comorbidity Index5

2.7 ± 1.8

Physical function2

38.4 ± 27.7

Obesity

33.6%

Fatigue3

5.2 ± 3.1

Depressive symptoms6

5.9 ± 5.4

Sleep4

 

4.4 ± 3.2

Smoking (current and past)

42.6%

Health perceptions

 

 

Health status rating7

63.5 ± 20.9

Satisfied, very satisfied with health

44.8%

Excellent, good health

46.4%

 

 

1 Pain: 1-10 rating, higher rating = greater pain.

2 Physical function:  SF-36 Physical Function subscale, range 0 – 100, higher score = better function.

3 Fatigue:  1-10 rating, higher rating = greater fatigue.

4 Sleep: 0-10 rating of problematic sleep, higher rating = more sleep problems.

5 Rheumatic Disease Comorbidity Index: Validated index that encompasses 11 comorbid illnesses (England BR, et al. Arthritis Care Res2015; 6: 865).  Score ranges from 0-9.

6 Depressive symptoms: from PHQ-8, higher score = more depressive symptoms.

7 Rating of health state from 0 (dead) – 100 (perfect health)

 

Table 2.  Regression results:  Independent predictors of health perceptions*

Significant associations

Health rating VAS§

Satisfied with health†

Excellent/good health†

Model 1:  SES variables only

 

 

 

Low education

-5.22 (0.10)

0.49 (0.30, 0.79)

0.52 (0.32, 0.87)

 

 

 

 

Model 2:  SES + lupus status, symptoms, other health factors

 

 

 

Low education

 

0.45 (0.19, 1.07)

 

Pain rating

-1.32 (.02)

0.79 (0.67, 0.93)

0.82 (0.69, 0.99)

Physical function

0.23 (<.0001)

1.02 (1.01, 1.04)

1.05 (1.03, 1.07)

SLAQ

-0.44 (.04)

0.90 (0.83, 0.97)

0.89 (0.82, 0.97)

Smoking (current or former)

-3.84 (.07)

0.46 (0.23, 0.95)

0.29 (0.13, 0.65)

Comorbidity index

 

 

0.78 (0.61, 0.99)

BILD

 

1.22 (0.99, 1.51)

 

* Table includes only predictors significant at p≤0.10.

§ Tabled values are beta (p-value) from multiple linear regression analysis

† Tabled values are odds ratio(95% confidence interval from multiple logistics regression analysis.


Disclosure: P. P. Katz, None; E. Chakravarty, None; R. S. Katz, None; K. Michaud, None.

To cite this abstract in AMA style:

Katz PP, Chakravarty E, Katz RS, Michaud K. Predictors of Health Perceptions Among Women with Lupus [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/predictors-of-health-perceptions-among-women-with-lupus/. Accessed January 27, 2021.
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