van Hal Tamara W, Mulder Michelle L M, Wenink Mark H, Vriezekolk Johanna E
Department of Rheumatology, Sint Maartenskliniek, P.O. Box 9011, 6500 GM, Nijmegen, The Netherlands.
Radboud Institute for Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands.
BMC Rheumatol. 2022 Aug 17;6(1):49. doi: 10.1186/s41927-022-00279-7.
Psoriatic arthritis can cause pain, disability, and permanent joint damage. This can lead to impairments in work and social participation. Little is known about the extent of these impairments in routine practice. With this study, we aim to examine the extent of work and activity impairment in (subgroups of) Dutch patients with psoriatic arthritis (PsA), and to examine determinants associated with this impairment.
This is an observational study using data collected from the electronic health records of PsA patients treated at the Sint Maartenskliniek, the Netherlands. Data about work and activity impairment were collected via the Work Productivity and Activity Impairment questionnaire. To compare our PsA-cohort with the Dutch general population, we used age- and sex-matched data derived from the Central Bureau of Statistics. Regression analyses were performed to examine determinants of work and activity impairment.
In total, 246 patients were included, of which 126 (51.2%) were female. Mean age (S.D.) was 55.7 (13.2) years. Compared with the Dutch general population, work for pay (WFP) was significantly lower in PsA (52.9% versus 62.6%, P < 0.001). In PsA, younger age and better physical function were associated with WFP status (P < 0.05). Higher disease activity, worse physical function, and worse mental health-related quality of life were associated with both more work and activity impairment (P < 0.05). Furthermore, reaching low disease activity status (LDA) according to Psoriatic ArthritiS Disease Activity Score (PASDAS; ≤ 3.2) was associated with less work and activity impairment than reaching LDA according to DAS28-CRP (≤ 2.9) (P < 0.05).
In PsA patients, worse physical function was associated with a lower likelihood of having WFP, and higher work and activity impairment. PASDAS LDA as a goal for treat to target, compared to DAS28-CRP, appears to favour the reduction of work and activity impairment.
银屑病关节炎可导致疼痛、残疾和永久性关节损伤。这可能会导致工作和社会参与方面的障碍。在日常实践中，对于这些障碍的程度知之甚少。通过本研究，我们旨在调查荷兰银屑病关节炎（PsA）患者（亚组）的工作和活动障碍程度，并研究与此类障碍相关的决定因素。
这是一项观察性研究，使用从荷兰圣马丁诊所接受治疗的PsA患者的电子健康记录中收集的数据。通过工作效率和活动障碍问卷收集有关工作和活动障碍的数据。为了将我们的PsA队列与荷兰普通人群进行比较，我们使用了从中央统计局获得的年龄和性别匹配的数据。进行回归分析以研究工作和活动障碍的决定因素。
总共纳入了246例患者，其中126例（51.2%）为女性。平均年龄（标准差）为55.7（13.2）岁。与荷兰普通人群相比，PsA患者的有偿工作（WFP）显著较低（52.9%对62.6%，P<0.001）。在PsA患者中，年龄较小和身体功能较好与WFP状态相关（P<0.05）。较高的疾病活动度、较差的身体功能以及较差的心理健康相关生活质量与更多的工作和活动障碍相关（P<0.05）。此外，根据银屑病关节炎疾病活动评分（PASDAS；≤3.2）达到低疾病活动状态（LDA）与根据DAS28-CRP（≤2.9）达到LDA相比，工作和活动障碍更少（P<0.05）。
在PsA患者中，较差的身体功能与从事WFP的可能性较低以及较高的工作和活动障碍相关。与DAS28-CRP相比，将PASDAS LDA作为治疗靶点的目标似乎有利于减少工作和活动障碍。
