SAT0099 THE RELATIONSHIP OF RHEUMATOLOGY ATTITUDES INDEX WITH OUTCOME MEASURES OF RHEUMATOID ARTHRITIS IN AN ASIAN PATIENT POPULATION
Authors: Jia Zhen Low, Chia Mun Woo, Chien Joo Lim, Khai Pang Leong, Ee Tzun Koh
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The Rheumatology Attitudes Index (RAI) is a questionnaire comprising of fifteen questions that assesses a patient's beliefs and perception of helplessness and the ability to control rheumatoid arthritis (RA). However, the relationship between RAI and patient demographics, disease activity and functional status is inadequately explored. <h3>Objectives</h3> We analysed the association of RAI with educational level, Physician's Global Assessment of Activity (DGA), Patient's Global Assessment of Activity (PGA), Disease Activity Score (DAS 28), and Health Assessment Questionnaire (HAQ). We also investigated if RAI is sensitive to change over a six-month period in comparison with DGA, PGA, DAS28 and HAQ. <h3>Methods</h3> All patients from Tan Tock Seng Hospital, a tertiary hospital in Singapore, who fulfilled the 1987 ACR criteria for RA, and completed the self-administered RAI questionnaire twice over six months were included. We analysed the DAS28, DGA, PGA and HAQ. Repeated measure ANOVA was used to analyse the association between RAI and educational level. Spearman correlation was used to study the association between RAI and the parameters DAS 28, HAQ, DGA and PGA, both cross-sectionally and longitudinally. We used SPSS version 19.0 (IBM Corp, Armonk, NY). P-value &lt;0.05 was considered statistically significant. All the tests were two sided. <h3>Results</h3> There were 501 patients suitable for study. The mean age of disease onset was 43 years and mean disease duration was 15 years. The majority were Chinese (83.4%), married (68.5%) and most (79.4%) received fewer than 10 years of education. About half (50.7%) of the participants suffered from hypertension, 13.6% diabetes mellitus, 61.5% hyperlipidaemia, 20.8% renal disease, 21.6% liver disease and 16.6% thyroid disorder. Patients with &lt;10 years education have higher RAI scores (p&lt;0.001) compared to those with &gt; 10 years of education. Cross-sectionally, weak positive correlation was found between RAI and DAS 28 (r = 0.225, p&lt;0.001), DGA (r= 0.107, p=0.017) and PGA (r= 0.283, p&lt;0.001). On the other hand, there was moderate positive correlation between RAI and HAQ (r=0.440, p&lt;0.001). Weak positive correlation was found between the change in RAI compared with changes in DAS 28 (r= 0.114, p=0.011), HAQ (r= 0.249, p&lt;0.001), DGA (r= 0.163, p&lt; 0.001) and PGA (r= 0.155, p=0.001). <h3>Conclusion</h3> Higher RAI scores denoting greater perceived helplessness were associated with higher RA activity, HAQ, PGA and DGA. RAI was responsive to change over a six-month period compared with these four parameters. High RAI score was also associated with lower educational level. Higher RAI scores reflects higher disease activity and worse functional status in a cross-sectional cohort and for the same patient longitudinally. <h3>Reference</h3> [1] Stein MJ, et al. Factor structure of the Arthritis Helplessness Index. J Rheumatol198815(3): 427-32 <h3>Disclosure of Interests</h3> None declared