FRI0642-HPR BARRIERS AND FACILITATORS FOR PHYSICAL ACTIVITY ARE MAINLY RELATED TO PSYCHOLOGICAL ISSUES IN INFLAMMATORY ARTHRITIS – A MIXED-METHODS STUDY OF 66 PATIENTS IN FRANCE.
Authors: T. Davergne, R. H. Moe, B. Fautrel, L. Gossec
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with inflammatory arthritis (IA) like (ankylosing spondylitis (AS), rheumatoid arthritis (RA), and psoriatic arthritis (PsA) are more prone to physical inactivity but derive specific benefits from regular physical activity (PA) (1). Barriers and facilitators to PA are key elements that have not yet been well described. Objectives: To assess if barriers and facilitators for PA in patients with IA are mostly related to disease, psychological, social or environmental factors. Methods: A list of the most important barriers and facilitators was derived from a systematic review of barriers and facilitators to PA in rheumatoid arthritis (2). This list was assessed for face validity by 11 experts from Rheumatology or physiotherapy then tested by 10 patients through structured interview. The list of barriers and facilitators was completed in a binary way: “barriers or facilitators are relevant to me” yes or no, for 66 patients in a monocentric, cross-sectional study. Then, patients assessed the level of each barrier or facilitator on a 0-10 scale. Statistics were descriptive. There was no imputation of missing data. Results: The study included 66 patients (27 axial spondyloarthritis, 26 rheumatoid arthritis, 13 psoriatic arthritis), mean age 52.0 (standard deviation (SD) 16.6) years, mean disease duration 14.3 (SD 11.7) years, 53% women. Disease activity was moderate (mean DAS28 2.1 (SD 1.1), mean BASDAI 2.8 (SD 1.4)), and 75.4% received a biologic. The main factors described by patients were related to the knowledge of the benefits of PA and symptoms (table 1). Psychological factors were more reported and social factors less reported as influential for PA. Table 1. Barriers and facilitators for physical activity reported by patients with inflammatory arthritis. Barriers or facilitators Categories Modifiable N (%) reporting this barrier or facilitator Level of patients reporting this item (0-10) (mean (SD)) Knowledge of benefits of physical activity for health Psych Yes 49 (78) 6.6 Knowledge of benefits of physical activity for mood Psych Yes 47 (75) 6.8 (3.4) Level of symptoms (pain, fatigue, lack of mobility) Phy Yes 44 (69) 5.7 (2.8) External reminders (eg: from health professionals, calendars…) Soc Yes 36 (57) 6.2 (3.1) Presence or absence of activity facilities (ex: green area for walking, gym …) Evmt No 34 (56) 6.3 (3.7) Lack of motivation Psych Yes 34 (55) 5.7 (3.2) Weather conditions Evmt No 33 (52) 5.7 (3.2) Confidence on how to exercise safely Psych Yes 31 (49) 6.0 (2.6) Contact and proximity with others during physical activity Soc No 29 (47) 6.1 (3.7) Presence or absence of support from others (friends, family) Soc No 26(42) 6.5 (3.9) Lack of time Evmt No 35 (40) 5.4 (3.4) Presence or absence of support and/or advice from healthcare professionals Soc Yes 25 (40) 6.0 (3.7) A belief that physical activity will make symptoms worse Psych Yes 17 (27) 4.8 (3.3) Lack of knowledge on which exercises to do and how much Psych Yes 17 (27) 4.7 (3.0) Psych = psychological, Evmt = environmental, Phy = physical, Soc = social Conclusion: The main factors that influence PA in patients with IA were mostly related to psychological aspects, and could be modifiable. The role of health professionals supporting patient PA is key. Interventions should be further explored to meet these important barriers and facilitators. References: [1] O’Dwyer T, Physical activity guidelines: is the message getting through to adults with rheumatic conditions? Rheumatol U K. 2014 [2] Davergne T, Thu0716-Hpr Major Barriers and Facilitators to Physical Activity in Rheumatoid Arthritis Are Related to Physical and Psychological Health, Setting and Social Environmental Factors: A Systematic Literature Review. Ann Rheum Dis. 2019 Disclosure of Interests: Thomas Davergne: None declared, Rikke Helene Moe: None declared, Bruno Fautrel Grant/research support from: AbbVie, Lilly, MSD, Pfizer, Consultant of: AbbVie, Biogen, BMS, Boehringer Ingelheim, Celgene, Lilly, Janssen, Medac MSD France, Nordic Pharma, Novartis, Pfizer, Roche, Sanofi Aventis, SOBI and UCB, Laure Gossec Grant/research support from: Lilly, Mylan, Pfizer, Sandoz, Consultant of: AbbVie, Amgen, Biogen, Celgene, Janssen, Lilly, Novartis, Pfizer, Sandoz, Sanofi-Aventis, UCB