Sex, Language and Age of Disease Onset Impact Illness Perceptions Among RA Patients

Susan J. Bartlett¹, Mariana Useche², Maria Celia Bazan Bardales³, Elizabeth Hazel⁴ and Ines Colmegna⁵, ¹Rheumatology, Johns Hopkins University School of Medicine, Baltimore, MD, ²Medicine, The Research Institute of the McGill University Health Centre, Montreal, QC, Canada, ³The Research Institute of the McGill University Health Centre, Montreal, QC, Canada, ⁴Rheumatology, McGill University Health Centre, Pointe-Claire, QC, Canada, ⁵The Research Institute of the McGill University Health Centre, Division of Rheumatology, Department of Medicine, McGill University, Montreal, Quebec, Canada, Montreal, QC, Canada

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: patient preferences and rheumatoid arthritis (RA)

Session Information

Date: Tuesday, October 23, 2018

Session Title: Patient Outcomes, Preferences, and Attitudes Poster II: Patient Perspectives

Session Type: ACR Poster Session C

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

Background/Purpose: Patients’ illness perceptions (IP) influence self-management, adherence, and outcomes. Little is known about how cultural background and the lived experiences influence IP among rheumatoid arthritis (RA) patients. We compared IP in people with inflammatory arthritis in men and women, by age of onset (juvenile idiopathic arthritis -JIA vs. RA), and by language/culture (English vs. French Canadian).

Methods: RA patients receiving care at an academic RA Clinic in Montreal, Canada completed the illness perception questionnaire –revised form (IPQ-R) between 2013 and 2015 during a clinic visit. Sociodemographic and RA clinical characteristics were also collected. T-tests and chi-square were used to compare characteristics and mean IPQ-R domain scores between groups by sex, diagnosis and language.

Results: Patients were mostly female, well-educated, spoke English, and had established RA. Over half (56%) were in remission or low disease activity. Mean HAQ (p<.01) and pain (p<.01) were significantly higher among women. Age, % speaking English, and education were significantly higher, and disease duration and CRP were lower in RA vs. JIA (p’s<.05). Sociodemographic and RA characteristics were similar by language. Personal and treatment control, timeline-acute/chronic, and disease consequences were similar among groups. As compared to those with RA, JIA patients had significantly higher mean Illness Coherence and Identity scores, and lower emotional representations Table 1. English speaking patients had significantly higher mean Timeline-cyclical scores; a similar trend was seen for women vs. men.

Conclusion: Illness perceptions related to the chronicity of their disease, and confidence that treatment and lifestyle choices could help control their disease were similarly high among all subgroups. As compared to people with RA, those with JIA reported a better understanding of disease-related symptoms, were more likely to identify having JIA as part of who they are, and reported less emotional distress in relation to their disease. English speaking patients and women reported less confidence in their ability to predict their symptoms and disease course. Understanding how patients view themselves, their inflammatory arthritis, and perceptions of timelines and controllability may offer new insight into ways to positively influence treatment expectations, adherence, and self- management.

Table 1. Mean scores on Illness Perception Domains by sex, diagnosis, and language.
	Sex	N	Mean	SD	Sig	Diagnosis	N	Mean	SD	Sig	Language	N	Mean	SD	Sig
Timeline – Cyclical	Women	122	14.0	3.3	.071	RA	120	13.7	3.4	.378	English	114	13.4	3.3	.025
Timeline – Cyclical	Men	27	12.7	3.1		JIA	29	14.3	3.1		French	35	14.9	3.3
Illness Coherence	Women	103	18.8	4.6	.350	RA	99	17.5	7.9	.036	English	97	18.2	7.8	.850
Illness Coherence	Men	22	15.8	14.4		JIA	26	20.9	3.5		French	28	18.5	5.4
Emotional Representations	Women	122	16.8	5.4	.203	RA	120	17.3	5.6	.001	English	114	16.5	5.5	.822
Emotional Representations	Men	27	15.3	6.2		JIA	29	13.4	4.3		French	35	16.7	6.0
Identity	Women	107	5.4	2.4	.545	RA	106	5.7	2.5	.005	English	102	5.5	2.5	.757
Identity	Men	25	5.7	2.5		JIA	26	4.3	1.9		French	30	5.3	2.2

Disclosure: S. J. Bartlett, None; M. Useche, None; M. C. Bazan Bardales, None; E. Hazel, None; I. Colmegna, None.

To cite this abstract in AMA style:

Bartlett SJ, Useche M, Bazan Bardales MC, Hazel E, Colmegna I. Sex, Language and Age of Disease Onset Impact Illness Perceptions Among RA Patients [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/sex-language-and-age-of-disease-onset-impact-illness-perceptions-among-ra-patients/. Accessed January 20, 2021.

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