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Abstract Number: 1597

Variability in Health Assessment Questionnaire Based on Type of Health Insurance Coverage and Rheumatology Practice

Jacqueline Stewart1, Regan Arendse2, Boulos Haraoui3, Michael Starr4, Denis Choquette5, Michelle Teo6, Dalton Sholter7, Emmanouil Rampakakis8, Eliofotisti Psaradellis9, Brendan Osborne10, Karina Maslova11, Cathy Tkaczyk10, Francois Nantel12 and Allen J Lehman11, 1Penticton Regional Hospital, Penticton, BC, Canada, 2University of Saskatchewan, Saskatoon, SK, Canada, 3Institut de Rhumatologie de Montréal and University of Montreal, Montreal, QC, Canada, 4Rheumatology, McGill University, Montreal, QC, Canada, 5Rheumatology Department, Institut de Rhumatologie de Montréal and University of Montreal, Montreal, QC, Canada, 6Rheumatology, Penticton Regional Hospital, Penticton, BC, Canada, 7Rheumatology Associates, Edmonton, AB, Canada, 8JSS Medical Research, St-Laurent, QC, Canada, 9JSS Medical Research, Montreal, QC, Canada, 10Medical Affairs, Janssen Inc., Toronto, ON, Canada, 11Janssen Inc., Toronto, ON, Canada, 1219 Green belt Dr, Janssen Inc., Toronto, ON, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Health Assessment Questionnaire, Outcome measures, registry and rheumatoid arthritis (RA)

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Session Information

Date: Monday, November 9, 2015

Session Title: Rheumatoid Arthritis - Clinical Aspects Poster II

Session Type: ACR Poster Session B

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

Background/Purpose :
Previous studies in rheumatoid arthritis (RA) have shown that patient
socioeconomic status (SES) impacts patient prognosis.
We
hypothesized that public vs. private healthcare coverage would be a surrogate
of low SES. The aim of this analysis was to assess the association between
patient health insurance coverage and disease parameters with emphasis on functional
activity in RA patients initiating treatment with anti-TNF agents in Canadian
routine clinical practice.

Methods :
BioTRAC is an ongoing, prospective registry of patients initiating treatment
for RA, ankylosing spondylitis, or psoriatic arthritis with infliximab (IFX) or
golimumab (GLM). Eligible people for this analysis included RA patients treated
with IFX who were enrolled since 2002 or with GLM enrolled since 2010. Independent
predictors of HAQ were identified using generalized linear models.

Results:
A total of 1144 patients were included of whom 598 (52.3%) had public
insurance. Patients with public insurance were older (59.7 vs. 51.8 years;
P<0.001), had longer disease duration (9.3 vs. 7.5 years; P=0.029), and were
more likely to be from British Columbia (81.2% vs. 18.8%) and Manitoba (68.8%
vs. 31.3%) but less likely to be from the Maritimes (30.6% vs. 69.4%)
(P<0.001). With respect to disease activity, patients with public insurance
had higher CDAI (37.3 vs. 30.3; P<0.001), DAS28 (6.0 vs. 5.2; P<0.001),
swollen joint count (11.0 vs. 8.5; P<0.001), tender joint count (12.8 vs.
10.3; P<0.001), patient global (62.1 vs. 55.5; P<0.001), and HAQ (1.74
vs. 1.36; P<0.001).  

Multivariate
analysis adjusting for age (P=0.028), gender (P<0.001), anti-TNF agent (P=0.227),
and CDAI (P<0.001) showed that private insurance type was a significant
independent predictor of lower HAQ (1.28 vs. 1.52; P<0.001). Furthermore,
rheumatology practice was also identified as a significant predictor of HAQ
(P=0.027; Figure 1).

Conclusion:
The results of this analysis suggest that,
upon adjusting for patient demographics and disease activity, significant
variation exists in the HAQ score based on the type of health insurance
coverage and the rheumatology practice which may reflect differences inherent
to the patient SES or to the manner of administration of the HAQ instrument.

 

 

Figure
1. Mean (SD) Adjusted HAQ by Participating Site


Disclosure: J. Stewart, Janssen Inc., 5; R. Arendse, Janssen Inc., 5; B. Haraoui, Janssen Inc.,, 5; M. Starr, Janssen Inc, 5; D. Choquette, Janssen Inc., 5,AbbVie, 5,Amgen, 5,Celgene, 5,BMS, 5,Pfizer Inc, 5; M. Teo, Janssen Inc., 5; D. Sholter, Janssen Inc., 5; E. Rampakakis, JSS Medical Research, a Contract Research Organization, 3; E. Psaradellis, JSS Medical Research, 3; B. Osborne, Janssen Inc., 3; K. Maslova, Janssen Inc., 3; C. Tkaczyk, Janssen Inc., 3; F. Nantel, Janssen Inc., 3; A. J. Lehman, Janssen Inc., 3.

To cite this abstract in AMA style:

Stewart J, Arendse R, Haraoui B, Starr M, Choquette D, Teo M, Sholter D, Rampakakis E, Psaradellis E, Osborne B, Maslova K, Tkaczyk C, Nantel F, Lehman AJ. Variability in Health Assessment Questionnaire Based on Type of Health Insurance Coverage and Rheumatology Practice [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/variability-in-health-assessment-questionnaire-based-on-type-of-health-insurance-coverage-and-rheumatology-practice/. Accessed July 2, 2022.
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