TY - JOUR
T1 - The Impact of Illness Perceptions and Coping on the Association Between Back Pain and Health Outcomes in Patients Suspected of Having Axial Spondyloarthritis: Data From the SPondyloArthritis Caught Early Cohort
AU - van Lunteren, Miranda
AU - Scharloo, Margreet
AU - Ez-Zaitouni, Zineb
AU - de Koning, Anoek
AU - Landewé, Robert
AU - Fongen, Camilla
AU - Ramonda, Roberta
AU - Kaptein, Ad A.
AU - van Gaalen, Floris A.
AU - van der Heijde, D. sirée
PY - 2018
Y1 - 2018
N2 - Objective: To investigate whether illness perceptions and coping influence the relationship between back pain and health outcomes in patients suspected of having axial spondyloarthritis (SpA). Methods: In the SPondyloArthritis Caught Early cohort, regression models were computed at baseline, with back pain intensity (range 0–10) as the determinant and health-related quality of life, the physical component summary score (PCS) and mental component summary (MCS) of the Short Form 36 (SF-36) health survey, or work productivity loss as outcomes. Subsequently, using Leventhal's Common-Sense Model of Self-Regulation, illness perceptions and, thereafter, coping were added to the models. Analyses were repeated for patients diagnosed and classified as having axial SpA according to the Assessment of SpondyloArthritis international Society axial SpA criteria (ASAS axial SpA), patients only diagnosed with axial SpA (axial SpA–diagnosed only), and those with chronic back pain. Results: A total of 424 patients (145 with ASAS axial SpA, 81 with only a diagnosis of axial SpA, and 198 with chronic back pain); 64% of the total group were female, the mean ± SD age was 30.9 ± 8.1 years, and the mean ± SD symptom duration was 13.3 ± 7.1 months) were studied. In all patients, the strength of the associations between back pain and the PCS, back pain and the MCS score, and back pain and loss of work productivity were decreased by adding illness perceptions to the model, but explained variance improved. Adding coping to these models did not change the results. Comparable results were observed in all subgroups. Conclusion: Illness perception, but not coping, is important in the relationship between back pain and HRQoL and work productivity loss in patients suspected of having axial SpA, irrespective of subgroup. This finding suggests that targeting illness perceptions could improve health outcomes in patients suspected of having axial SpA.
AB - Objective: To investigate whether illness perceptions and coping influence the relationship between back pain and health outcomes in patients suspected of having axial spondyloarthritis (SpA). Methods: In the SPondyloArthritis Caught Early cohort, regression models were computed at baseline, with back pain intensity (range 0–10) as the determinant and health-related quality of life, the physical component summary score (PCS) and mental component summary (MCS) of the Short Form 36 (SF-36) health survey, or work productivity loss as outcomes. Subsequently, using Leventhal's Common-Sense Model of Self-Regulation, illness perceptions and, thereafter, coping were added to the models. Analyses were repeated for patients diagnosed and classified as having axial SpA according to the Assessment of SpondyloArthritis international Society axial SpA criteria (ASAS axial SpA), patients only diagnosed with axial SpA (axial SpA–diagnosed only), and those with chronic back pain. Results: A total of 424 patients (145 with ASAS axial SpA, 81 with only a diagnosis of axial SpA, and 198 with chronic back pain); 64% of the total group were female, the mean ± SD age was 30.9 ± 8.1 years, and the mean ± SD symptom duration was 13.3 ± 7.1 months) were studied. In all patients, the strength of the associations between back pain and the PCS, back pain and the MCS score, and back pain and loss of work productivity were decreased by adding illness perceptions to the model, but explained variance improved. Adding coping to these models did not change the results. Comparable results were observed in all subgroups. Conclusion: Illness perception, but not coping, is important in the relationship between back pain and HRQoL and work productivity loss in patients suspected of having axial SpA, irrespective of subgroup. This finding suggests that targeting illness perceptions could improve health outcomes in patients suspected of having axial SpA.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85052319125&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/29609197
U2 - https://doi.org/10.1002/acr.23566
DO - https://doi.org/10.1002/acr.23566
M3 - Article
C2 - 29609197
SN - 2151-464X
VL - 70
SP - 1829
EP - 1839
JO - Arthritis care and research
JF - Arthritis care and research
IS - 12
ER -