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Charzyńska E, Offenbächer M, Halverson K, Hirsch JK, Kohls N, Hanshans C, Sirois F, Toussaint L. Profiles of well-being and their associations with self-forgiveness, forgiveness of others, and gratitude among patients with rheumatic and musculoskeletal diseases. Br J Health Psychol 2024. [PMID: 39187474 DOI: 10.1111/bjhp.12749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 08/02/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES Patients with rheumatic and musculoskeletal diseases (RMDs) often experience poor well-being. Common limitations of the studies on this topic involve using variable-centred and deficit-based approaches. In this study, we used the person-centred approach to identify profiles of positive (life satisfaction and health status) and negative (depression, anxiety, fatigue, and stress) indicators of well-being among patients with RMDs. Moreover, we tested self-forgiveness, forgiveness of others, gratitude, and sociodemographics as contributors to latent profile membership. DESIGN A cross-sectional questionnaire survey. METHODS Using a latent profile analysis, we investigated well-being profiles among 892 patients with RMDs (759 patients with arthritis and 133 with fibromyalgia [FM]) and examined the correlates of latent profile membership. RESULTS We identified four profiles of well-being: (1) 'life dissatisfaction' (9.2%), (2) 'high well-being' (43.4%), (3) 'suboptimal well-being' (35.2%), and (4) 'very poor well-being' (12.2%). Members of Profile 2 had higher levels of self-forgiveness and gratitude than members of the remaining profiles, had higher levels of forgiveness of others than Profile 3, and were older than members of Profile 4. Moreover, members of Profile 2 had a higher proportion of patients with arthritis relative to those with FM than all other profiles and men to women than Profile 4. CONCLUSIONS Patients with RMDs are heterogeneous in terms of well-being. Self-forgiveness, gratitude, and forgiveness of others may serve as psychological capital that enhances patients' well-being. Special attention should be paid to patients with FM, women, and younger patients since they can be especially susceptible to poor well-being.
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Affiliation(s)
- Edyta Charzyńska
- Faculty of Social Sciences, Institute of Psychology, Institute of Pedagogy, University of Silesia in Katowice, Katowice, Poland
| | - Martin Offenbächer
- Gastein Healing Gallery, Bad Gastein, Austria
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
| | | | - Jameson K Hirsch
- Department of Psychiatry and Behavioral Sciences, East Tennessee State University, Johnson City, Tennessee, USA
| | - Niko Kohls
- Faculty for Applied Natural Sciences and Health, University of Applied Sciences and Arts, Coburg, Germany
| | - Christian Hanshans
- Department of Applied Sciences and Mechatronics, University of Applied Science, Munich, Germany
| | | | - Loren Toussaint
- Department of Psychology, Luther College, Decorah, Iowa, USA
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Pocha C, Chrusciel T, Salas J, Eisen S, Callahan L, Ory MG, Scherrer JF, Gebauer S. Neighborhood Characteristics & Walking Behavior Among Adults with Arthritis: An NHIS Study. Arthritis Care Res (Hoboken) 2024. [PMID: 39155669 DOI: 10.1002/acr.25418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVE This study investigated the association of perceived neighborhood qualities with likelihood of transit walking, leisure walking, neighborhood walking, and meeting physical activity (PA) recommendations among US adults with arthritis. METHODS This cross-sectional study utilized 2020 National Health Interview Survey data. Included participants were adults reporting clinician-diagnosed arthritis and who reported the ability to walk. Exposures of interest were perceived neighborhood attributes. Outcomes were transit walking, leisure walking, neighborhood walking, and meeting PA recommendations. Standardized mean difference percent (SMD%) was used to assess relationships between exposures and outcomes with SMD% >10% resulting in inclusion in final adjusted multivariate logistic regression models for odds of outcomes. All analyses were weighted to account for complex survey methodology. RESULTS The analytic sample included 7,322 adults with arthritis. Fully adjusted logistic regression models showed presence of roads to walk on was associated with meeting PA recommendations (OR=1.26[95%CI=1.07-1.49]). Three attributes were positively associated with transit walking, while safety from crime was negatively associated (OR=2.33[95%CI=1.75-3.10], OR=1.49[95%CI=1.17-1.91], OR=1.67[95%CI=1.34-2.08]), OR=0.70[95%CI=0.53-0.92]). Roads to walk and places to walk and relax were associated with leisure and neighborhood walking (OR=1.46[95%CI=1.21-1.76], OR=1.56[95%CI=1.34-1.82], OR=1.58[95%CI=1.29-1.93], OR=1.63[95%CI=1.40-1.90], respectively). CONCLUSION This study identified several neighborhood characteristics associated with higher likelihood of walking behaviors among adults with arthritis. Factors associated with walking behavior varied by type of walking. The shared correlates between leisure and neighborhood walking imply they occur in the same setting. Patients with arthritis may benefit from exercise recommendations that are informed by the presence or absence of facilitating infrastructure in their neighborhoods.
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Affiliation(s)
- Ciri Pocha
- Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | | | - Joanne Salas
- Saint Louis University School of Medicine, St. Louis, MO, U.S.A
| | - Seth Eisen
- Washington University School of Medicine, St. Louis, MO, U.S.A
| | - Leigh Callahan
- University of North Carolina-Chapel Hill, Chapel Hill, NC, U.S.A
| | - Marcia G Ory
- Texas A&M Health Science Center School of Public Health, College Station, TX, U.S.A
| | | | - Sarah Gebauer
- Saint Louis University School of Medicine, St. Louis, MO, U.S.A
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3
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Axon DR. Investigating the Variables Associated with Physical Exercise Status among United States Adults with Arthritis. J Clin Med 2024; 13:4526. [PMID: 39124792 PMCID: PMC11313260 DOI: 10.3390/jcm13154526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 07/19/2024] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
Background/Objectives: Arthritis is a chronic, debilitating condition affecting millions of United States (US) adults. Regular physical exercise is particularly important for adults with arthritis. This study aimed to investigate the characteristics associated with regular physical exercise in US adults with arthritis. Methods: This cross-sectional database study used 2021 Medical Expenditure Panel Survey data and included US adults (age ≥ 18) alive with arthritis. A multivariable logistic regression model was developed to test the association of the following variables with regular physical exercise (defined as moderate-vigorous intensity exercise for ≥30 min ≥5 times weekly; yes, no): age, sex, Hispanic, race, census region, marriage status, schooling, employment, health insurance, household income, mental health, general health, smoking status, chronic conditions, pain, and functional limitations. Results: Overall, 5091 people (regular physical exercise n = 2331, no regular physical exercise n = 2760) were involved in this analysis. Most were female, non-Hispanic, white, married, had schooling beyond high school, were unemployed, had private health insurance, had mid-high household income, had good mental health, had good general health, were non-smokers, had two or more chronic conditions, had little/moderate pain, and did not have a functional limitation. In multivariable logistic regression analysis, male vs. female sex (odds ratio [OR] = 1.440, 95% confidence interval [CI] = 1.185-1.749), employed vs. unemployed (OR = 1.277, 95% CI = 1.005-1.624), good vs. poor general health (OR = 2.174, 95% CI = 1.673-2.824), little/moderate vs. quite a bit/extreme pain (OR = 1.418, 95% CI = 1.109-1.818), and no functional limitation (OR = 1.592, 95% CI = 1.282-1.980) were associated with higher odds of reporting regular physical exercise, while Midwest vs. West census region (OR = 0.698, 95% CI = 0.521-0.935) was associated with lower odds of reporting regular physical exercise. Conclusions: This study identified variables associated with regular physical exercise among US adults with arthritis. Further work is needed to develop interventions for characteristics that may help increase exercise and, subsequently, health outcomes in this population.
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Affiliation(s)
- David R Axon
- Department of Pharmacy Practice & Science, R. Ken Coit College of Pharmacy, The University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85721, USA
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Dobson KG, Gignac MAM, Tucker L, Jetha A. Double Trouble! Do Workplace Supports Mitigate Lost Productivity for Young Workers with Both Severe Rheumatic Diseases and Depressive Symptoms? JOURNAL OF OCCUPATIONAL REHABILITATION 2024:10.1007/s10926-024-10217-8. [PMID: 38960928 DOI: 10.1007/s10926-024-10217-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND The objectives of this longitudinal study were to understand how comorbid rheumatic disease and depression symptoms were associated with at-work productivity among young adults, and to examine whether workplace support modified this association. METHODS Seventy-six Canadian young adults who were employed and living with a rheumatic disease were surveyed three times over 27 months. Morbidity was defined by whether participants reported severe rheumatic disease symptoms and/or depressive symptoms. Participants were asked about presenteeism, absenteeism, and whether the workplace support needs (accommodation and benefit availability and use) were met. Generalized estimating equations were used to address study objectives. RESULTS Seventeen participants experienced neither severe rheumatic disease nor depressive symptoms (no morbidity), 42 participants experienced either severe rheumatic disease or depressive symptoms (single morbidity), and 17 participants reported comorbidity at baseline. Participants with comorbidity reported greater presenteeism scores and were most likely to report absenteeism, compared to the other two morbidity levels. Having workplace support needs met was associated with decreased presenteeism over the 27-month period among participants with no and a single morbidity. Conversely, unmet support need was associated with greater presenteeism for participants with comorbidity. Having workplace support needs met did not modify the association between morbidity and absenteeism. CONCLUSION Comorbid rheumatic disease and depression burden reduce productivity among young adults. A supportive work environment has the potential to address at-work productivity challenges. Additional research is needed to understand how workplace supports coupled with clinical interventions may tackle challenges at work for young adults living with rheumatic disease and depression.
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Affiliation(s)
- Kathleen G Dobson
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Monique A M Gignac
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Lori Tucker
- University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital, Vancouver, BC, Canada
| | - Arif Jetha
- Institute for Work and Health, Suite 1800 400 University Avenue, Toronto, ON, M5G1S5, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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Cai J, Parker M, Tekwe C, Bidulescu A. Food insecurity and mental health among US adults during the COVID-19 pandemic: Results from National Health Interview Survey, 2020-2021. J Affect Disord 2024; 356:707-714. [PMID: 38608771 DOI: 10.1016/j.jad.2024.04.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/07/2024] [Accepted: 04/09/2024] [Indexed: 04/14/2024]
Abstract
OBJECTIVE To examine socio-demographic disparities in food insecurity during the COVID-19 pandemic and the association between food insecurity and mental health among US adults overall and communities vulnerable to food insecurity. METHODS A cross-sectional study was conducted using the 2020-2021 National Health Interview Survey of 57,456 US adults. Weighted multivariable logistic regression models were used to estimate the association between food insecurity and anxiety or depression symptoms in overall US adults and subgroups including young adults (18-34 years), females, Hispanic people, non-Hispanic Black people, individuals with prior COVID-19 infection, the unemployed, low-income participants, participants with children, and Supplemental Nutrition Assistance Program (SNAP) participants. RESULTS Young or middle age, female sex, Hispanic/non-Hispanic Black/other race/ethnicity, lower education level, unmarried/other marital status, unemployment, being below the federal poverty level, and greater number of persons in the household were associated with food insecurity (AOR ranged from 1.35 to 2.70, all p < 0.05). Food insecurity was independently associated with anxiety (AOR = 2.67, 99 % CI: 2.33, 3.06) or depression (AOR = 3.04, 99 % CI: 2.60, 3.55) symptoms in the overall adults. Significant associations between food insecurity and anxiety or depression symptoms were also observed in all subgroups (AOR ranged from 1.95 to 3.28, all p < 0.0001). Compared with overall adults, the magnitude of the association was greater for participants with children, females (for depression only), and non-Hispanic Black people (for depression only). LIMITATIONS The cross-sectional design prevents inference of causality. CONCLUSIONS Comprehensive policies are needed to ensure accessible and affordable food resources to reduce disparities in food insecurity and improve mental health, especially for those socioeconomically disadvantaged communities.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Maria Parker
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Carmen Tekwe
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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Gheisary Z, Hoja I, Liu J, Papagerakis P, Weber LP, Fenton M, Katselis GS, Lieffers JRL, Papagerakis S. Association of Sleep Quality and General, Mental, and Oral Health with Lifestyle Traits (Dietary Intake, Smoking Status) in Arthritis: A Cross-Sectional Study from the Canadian Community Health Survey (CCHS). Nutrients 2024; 16:2091. [PMID: 38999838 PMCID: PMC11243648 DOI: 10.3390/nu16132091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/23/2024] [Accepted: 06/24/2024] [Indexed: 07/14/2024] Open
Abstract
Arthritis is associated with health challenges. Lifestyle traits are believed to influence arthritis development and progression; however, data to support personalized treatment regimens based on holistic lifestyle factors are missing. This study aims to provide a comprehensive list of associations between lifestyle traits and the health status of individuals with arthritis in the Canadian population, using binary logistic regression analysis on data from the Canadian Community Health Survey, which includes 104,359 respondents. Firstly, we explored the association between arthritis and various aspects of health status including self-reported lifestyle factors. Secondly, we examined the associations between self-reported dietary intake and smoking status with general, mental, and oral health, and sleep disturbance among individuals both with and without arthritis. Our analysis revealed that individuals with arthritis reported considerably poorer general, mental, and oral health, and poorer sleep quality compared to those without arthritis. Associations were also found between self-reported dietary intake and various measures of health status in individuals with arthritis. Smoking and exposure to passive smoking were associated not only with arthritis but also with compromised sleep quality and poorer general, mental, and oral health in people with and without arthritis. This study highlights the need for personalized and holistic approaches that may include a combination of dietary interventions, oral health improvements, sleep therapies, and smoking cessation for improved arthritis prevention and care.
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Affiliation(s)
- Zohre Gheisary
- Department of Biochemistry, Microbiology, and Immunology, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada;
| | - Ibrahim Hoja
- Laboratory of Precision Oral Health and Chronobiology, Faculty of Dentistry, Laval University, Dental Medicine Pavilion, 2420, rue de la Terrasse, Quebec City, QC G1V 0A6, Canada; (I.H.); (P.P.)
- Health Sciences, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Juxin Liu
- Department of Mathematics and Statistics, College of Arts and Science, University of Saskatchewan, 106 Wiggins Road, Saskatoon, SK S7N 5E6, Canada;
| | - Petros Papagerakis
- Laboratory of Precision Oral Health and Chronobiology, Faculty of Dentistry, Laval University, Dental Medicine Pavilion, 2420, rue de la Terrasse, Quebec City, QC G1V 0A6, Canada; (I.H.); (P.P.)
| | - Lynn P. Weber
- Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, 52 Campus Drive, Saskatoon, SK S7N 5B4, Canada;
| | - Mark Fenton
- Division of Respirology, Critical Care, and Sleep Medicine, College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada;
| | - George S. Katselis
- Department of Medicine, Canadian Centre for Rural and Agricultural Health, College of Medicine, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK S7N 2Z4, Canada;
| | - Jessica R. L. Lieffers
- College of Pharmacy and Nutrition, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N 5E5, Canada
| | - Silvana Papagerakis
- Laboratory of Precision Oral Health and Chronobiology, Faculty of Dentistry, Laval University, Dental Medicine Pavilion, 2420, rue de la Terrasse, Quebec City, QC G1V 0A6, Canada; (I.H.); (P.P.)
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Wang X, Zhang T, Gu X, Xu L, Li F, Zhai Y, Wu M, Lin J. Depressive symptoms and associated factors among older patients with arthritis: evidence from a community-based study in eastern China. Front Public Health 2024; 12:1375106. [PMID: 38827624 PMCID: PMC11140034 DOI: 10.3389/fpubh.2024.1375106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Depressive symptoms are often experienced by patients with arthritis and are correlated with poor health outcomes. However, the association between depressive symptoms and multidimensional factors (sociodemographic characteristics, health conditions, health behaviors, and social support) among older patients with arthritis in China remains poorly understood. This study aimed to explore the prevalence of depressive symptoms in older patients with arthritis in eastern China and identify the associated factors. Methods We analyzed data of 1,081 older patients with arthritis using secondary data from 2014 to 2020 from a community-based ongoing study initiated in 2014 in eastern China. The prevalence of depressive symptoms was calculated, and univariate and multilevel logistic regression analyses were used to identify the associated factors. Results The mean age of older patients with arthritis was 69.16 ± 7.13 years; 42.92% were men and 57.08% were women. The prevalence of depressive symptoms in older patients with arthritis was 14.99% (95% confidence interval: 12.91-17.26%), about 1.8 times higher than that in older adults without arthritis (8.49%, p < 0.001). Multilevel logistic regression identified perception of poor economic status (odds ratio [OR] = 5.52, p < 0.001), multimorbidity (OR = 1.96, p = 0.001), limitations in activities of daily living (OR = 2.36, p = 0.004), and living alone (OR = 3.13, p = 0.026) as factors positively associated with depressive symptoms. Patients diagnosed with arthritis at an older age had lower odds of experiencing depressive symptoms (OR = 0.67, p = 0.046). Conclusion Screening for depressive symptoms is essential among older patients with arthritis, especially those who perceive themselves as having a poor economic status, are diagnosed at an earlier age, have multimorbidity, have limitations in activities of daily living, and live alone. The associations of age at arthritis diagnosis and dietary behaviors with depressive symptoms require further research.
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Affiliation(s)
| | | | | | | | | | | | | | - Junfen Lin
- Department of Public Health Surveillance and Advisory, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Simic K, Savic B, Knezevic NN. Pain Catastrophizing: How Far Have We Come. Neurol Int 2024; 16:483-501. [PMID: 38804476 PMCID: PMC11130925 DOI: 10.3390/neurolint16030036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 04/19/2024] [Accepted: 04/24/2024] [Indexed: 05/29/2024] Open
Abstract
The perception of pain is strongly influenced by various social, emotional, and cognitive factors. A psychological variable which has consistently been shown to exert its influence on pain is a cognitive process referred to as pain catastrophizing. Numerous studies have found it to be a strong predictor of pain intensity and disability across different clinical populations. It signifies a maladaptive response to pain marked by an exaggerated negative assessment, magnification of symptoms related to pain, and, in general, a tendency to experience marked pain-related worry, as well as experiencing feelings of helplessness when it comes to dealing with pain. Pain catastrophizing has been correlated to many adverse pain-related outcomes, including poor treatment response, unsatisfactory quality of life, and high disability related to both acute and chronic pain. Furthermore, there has been consistent evidence in support of a correlation between pain catastrophizing and mental health disorders, such as anxiety and depression. In this review, we aim to provide a comprehensive overview of the current state of knowledge regarding pain catastrophizing, with special emphasis on its clinical significance, and emerging treatment modalities which target it.
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Affiliation(s)
- Katarina Simic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Boris Savic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
| | - Nebojsa Nick Knezevic
- Department of Anesthesiology, Advocate Illinois Masonic Medical Center, Chicago, IL 60657, USA; (K.S.); (B.S.)
- Department of Anesthesiology, University of Illinois, Chicago, IL 60612, USA
- Department of Surgery, University of Illinois, Chicago, IL 60612, USA
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Cai J, Bidulescu A. E-cigarette use or dual use of E-cigarette and combustible cigarette and mental health and cognitive impairment: Findings from the National Health Interview Survey, 2020-2021. J Affect Disord 2024; 351:878-887. [PMID: 38211743 DOI: 10.1016/j.jad.2024.01.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND Studies on the association between e-cigarette use and mental health are mostly among adolescents and young adults, leaving limited evidence of this association among general US adults. Besides, few studies have examined how e-cigarette use or dual use of e-cigarette and combustible cigarette is related to cognitive function. METHODS Cross-sectional data of 56,734 adults from the 2020-2021 National Health Interview Survey were analyzed. Weighted multivariable logistic regression models were applied to examine the independent association between e-cigarette use or dual use and anxiety symptoms, depression symptoms, serious psychological distress (SPD), and cognitive impairment. RESULTS Compared with never e-cigarette users, current e-cigarette users had 2.10-fold (95 % CI: 1.84, 2.39), 2.53-fold (95 % CI: 2.13, 3.00), 2.02-fold (95 % CI: 1.47, 2.76), and 2.00-fold (95 % CI: 1.47, 2.72) higher odds of reporting anxiety symptoms, depression symptoms, SPD, and cognitive impairment, respectively. Former e-cigarette use was also associated with all three mental conditions and cognitive impairment (AOR ranged from 1.38 to 2.53, all P < 0.01). Dual users were more likely to report all three mental conditions and cognitive impairment than those who never used combustible cigarette and e-cigarette (AOR ranged from 1.89 to 2.83, all P < 0.01). Dual users also had a greater likelihood of having anxiety or depression symptoms than exclusive combustible cigarette users (AOR ranged from 1.46 to 1.47, all P < 0.01). CONCLUSIONS E-cigarette use or dual use is associated with poor mental health and cognitive impairment among US adults. Regulations on e-cigarette use are needed to prevent mental illness and improve cognitive function.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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Naik H, Tran KC, Staples JA, Perlis RH, Levin A. Psychiatric Symptoms, Treatment Uptake, and Barriers to Mental Health Care Among US Adults With Post-COVID-19 Condition. JAMA Netw Open 2024; 7:e248481. [PMID: 38662370 PMCID: PMC11046346 DOI: 10.1001/jamanetworkopen.2024.8481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/27/2024] [Indexed: 04/26/2024] Open
Abstract
Importance Psychiatric symptoms are reportedly common among adults with post-COVID-19 condition (PCC). However, nationally representative data regarding symptom prevalence, treatment uptake, and barriers to care are needed to inform the development of care models. Objectives To evaluate the prevalence of psychiatric symptoms in US adults with PCC compared with those without PCC and assess treatment uptake and cost-related barriers to treatment. Design, Setting, and Participants Data from the 2022 National Health Interview Survey (NHIS), a nationally representative US cross-sectional survey, were analyzed between October 2023 and February 2024. Exposure Current PCC, defined as new symptoms following SARS-CoV-2 infection lasting more than 3 months and ongoing at the time of interview. Main Outcomes and Measures Depression symptoms were evaluated by the Patient Health Questionnaire-8 and anxiety symptoms were assessed using the General Anxiety Disorder-7 instrument. Participants were classified as having received treatment if they received mental health counseling or therapy or medications for mental health. Sleep difficulties, cognitive difficulties, disabling fatigue, and cost-related barriers were assessed from additional NHIS questions. Results Of the 25 122 participants representing approximately 231 million US adults (median [IQR] age, 46 [32-61] years; 49.8% male and 50.2% female participants), a weighted prevalence (wPr) of 3.4% (95% CI, 3.1%-3.6%) had current PCC. Compared with other US adults, participants with current PCC were more likely to have depression symptoms (wPr, 16.8% vs 7.1%; adjusted odds ratio [AOR], 1.96; 95% CI, 1.51-2.55), anxiety symptoms (wPr, 16.7% vs 6.3%; AOR, 2.21; 95% CI, 1.53-3.19), sleep difficulties (wPr, 41.5% vs 22.7%; AOR 1.95; 95% CI, 1.65-2.29), cognitive difficulties (wPr, 35.0% vs 19.5%; AOR, 2.04; 95% CI, 1.66-2.50), and disabling fatigue (wPr, 4.0% vs 1.6%; AOR, 1.85; 95% CI, 1.20-2.86). Among participants who had depression or anxiety symptoms, those with PCC had a similar likelihood of not having received treatment (wPr, 28.2% vs 34.9%; AOR, 1.02; 95% CI, 0.66-1.57). However, participants with current PCC were more likely to report a cost-related barrier to accessing mental health counseling or therapy (wPr, 37.2% vs 23.3%; AOR, 2.05; 95% CI, 1.40-2.98). Conclusions and Relevance The findings of this study suggest that people with PCC have a higher prevalence of psychiatric symptoms than other adults but are more likely to experience cost-related barriers to accessing therapy. Care pathways for PCC should consider prioritizing mental health screening and affordable treatment.
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Affiliation(s)
- Hiten Naik
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
| | - Karen C. Tran
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada
| | - John A. Staples
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Centre for Clinical Epidemiology & Evaluation, Vancouver, British Columbia, Canada
| | - Roy H. Perlis
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Adeera Levin
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
- Post–COVID-19 Interdisciplinary Clinical Care Network, Vancouver, British Columbia, Canada
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Chen H, Fang X, Ma K, Zhou Z, Lai Y, Liang H, Ding C, Zhu Z. Trends in the prevalence of major depressive symptoms among adults with arthritis in the United States, 2005-2018. J Psychosom Res 2024; 178:111591. [PMID: 38232456 DOI: 10.1016/j.jpsychores.2024.111591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/07/2024] [Accepted: 01/07/2024] [Indexed: 01/19/2024]
Affiliation(s)
- Haowei Chen
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaofeng Fang
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Kang Ma
- The Second Clinical Medical School, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhounan Zhou
- The Second Clinical Medical School, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Yuxin Lai
- The Second Clinical Medical School, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Huiting Liang
- The Second Clinical Medical School, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Changhai Ding
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China; Department of Rheumatology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China; Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
| | - Zhaohua Zhu
- Clinical Research Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
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12
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Naughton N, Stern BZ, Bakshi P, Goloff SE, Doerrer SB. Patients living with upper extremity arthritis may experience limitations in physical, mental, and social health: A technical report. J Hand Ther 2024:S0894-1130(23)00177-1. [PMID: 38278699 DOI: 10.1016/j.jht.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/31/2023] [Accepted: 12/08/2023] [Indexed: 01/28/2024]
Affiliation(s)
| | - Brocha Z Stern
- Institute for Health Care Delivery Science, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Fallon EA, Boring MA, Foster AL, Stowe EW, Lites TD, Odom EL, Seth P. Prevalence of Diagnosed Arthritis - United States, 2019-2021. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2023; 72:1101-1107. [PMID: 37824422 PMCID: PMC10578950 DOI: 10.15585/mmwr.mm7241a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
Arthritis includes approximately 100 conditions that affect the joints and surrounding tissues. It is a leading cause of activity limitations, disability, and chronic pain, and is associated with dispensed opioid prescriptions, substantially contributing to health care costs. Combined 2019-2021 National Health Interview Survey data were analyzed to update national prevalence estimates of self-reported diagnosed arthritis. An estimated 21.2% (18.7% age-standardized) of U.S. adults aged ≥18 years (53.2 million) had diagnosed arthritis during this time frame. Age-standardized arthritis prevalences were higher among women (20.9%) than men (16.3%), among veterans (24.2%) than nonveterans (18.5%), and among non-Hispanic White (20.1%) than among Hispanic or Latino (14.7%) or non-Hispanic Asian adults (10.3%). Adults aged ≥45 years represent 88.3% of all U.S. adults with arthritis. Unadjusted arthritis prevalence was high among adults with chronic obstructive pulmonary disease (COPD) (57.6%), dementia (55.9%), a disability (54.8%), stroke (52.6%), heart disease (51.5%), diabetes (43.1%), or cancer (43.1%). Approximately one half of adults aged ≥65 years with COPD, dementia, stroke, heart disease, diabetes, or cancer also had a diagnosis of arthritis. These prevalence estimates can be used to guide public health policies and activities to increase equitable access to physical activity opportunities within the built environment and other arthritis-appropriate, evidence-based interventions.
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14
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Webb S, Drake C, Coffman CJ, Sullivan C, Sperber N, Tucker M, Zullig LL, Hughes JM, Kaufman BG, Pura JA, Anderson L, Hastings SN, Van Houtven CH, Abbate LM, Hoenig H, Ballengee LA, Wang V, Allen KD. Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial. Implement Sci Commun 2023; 4:125. [PMID: 37828564 PMCID: PMC10571277 DOI: 10.1186/s43058-023-00502-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 09/09/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient approaches for delivering exercise-based PT to patients with knee OA. A prior randomized controlled trial (RCT) showed that a 6-session Group Physical Therapy Program for Knee OA (Group PT) yields equivalent or greater improvements in pain and functional outcomes compared with traditional individual PT, while requiring fewer clinician hours per patient to deliver. This manuscript describes the protocol for a hybrid type III effectiveness-implementation trial comparing two implementation packages to support delivery of Group PT. METHODS In this 12-month embedded trial, a minimum of 16 Veterans Affairs Medical Centers (VAMCs) will be randomized to receive one of two implementation support packages for their Group PT programs: a standard, low-touch support based on Replicating Effective Programs (REP) versus enhanced REP (enREP), which adds tailored, high-touch support if sites do not meet Group PT adoption and sustainment benchmarks at 6 and 9 months following launch. Implementation outcomes, including penetration (primary), adoption, and fidelity, will be assessed at 6 and 12 months (primary assessment time point). Additional analyses will include patient-level effectiveness outcomes (pain, function, satisfaction) and staffing and labor costs. A robust qualitative evaluation of site implementation context and experience, as well as site-led adaptations to the Group PT program, will be conducted. DISCUSSION To our knowledge, this study is the first to evaluate the impact of tailored, high-touch implementation support on implementation outcomes when compared to standardized, low-touch support for delivering a PT-based intervention. The Group PT program has strong potential to become a standard offering for PT, improving function and pain-related outcomes for patients with knee OA. Results will provide information regarding the effectiveness and value of this implementation approach and a deeper understanding of how healthcare systems can support wide-scale adoption of Group PT. TRIAL REGISTRATION This study was registered on March 7, 2022 at ClinicalTrials.gov (identifier NCT05282927 ).
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Affiliation(s)
- Sara Webb
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Connor Drake
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Cynthia J Coffman
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Caitlin Sullivan
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Nina Sperber
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Matthew Tucker
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Leah L Zullig
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Jaime M Hughes
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA
- Section On Gerontology and Geriatric Medicine, Division of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Brystana G Kaufman
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - John A Pura
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- AstraZeneca, Durham, NC, USA
| | - Livia Anderson
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
| | - Susan N Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Geriatric Research, Education, and Clinical Center, Durham VA Health Care System, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Courtney H Van Houtven
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Margolis Center for Health Policy, Duke University, Durham, NC, USA
| | - Lauren M Abbate
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- VA Eastern Colorado Geriatric Research Education and Clinical Center and University of Colorado School of Medicine, Aurora, CO, USA
| | - Helen Hoenig
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
- Physical Medicine and Rehabilitation Services, Durham VA Health Care System, Durham, NC, USA
| | - Lindsay A Ballengee
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Virginia Wang
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA
- Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
- Margolis Center for Health Policy, Duke University, Durham, NC, USA
- Department of Medicine, Duke University School of Medicine, Durham, NC, USA
| | - Kelli D Allen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA Health Care System, Durham, NC, USA.
- Department of Medicine & Thurston Arthritis Research Center, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
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15
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He D, Fan Y, Qiao Y, Liu S, Zheng X, Zhu J. Depressive symptom trajectories and new-onset arthritis in a middle-aged and elderly Chinese population. J Psychosom Res 2023; 172:111422. [PMID: 37379786 DOI: 10.1016/j.jpsychores.2023.111422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/11/2023] [Accepted: 06/20/2023] [Indexed: 06/30/2023]
Abstract
OBJECTIVE Previous studies reported that depression was associated with a high risk of arthritis. However, the effect of different long-term depressive symptom trajectory patterns on the risk of arthritis has not been evaluated. Our study aimed to explore the association between depressive symptom trajectories and the risk of arthritis. METHODS A total of 5583 participants from the China Health and Retirement Longitudinal Study from 2011 to 2018 were included in this analysis. Group-based trajectory modeling was used to identify depressive symptom trajectories, and a multivariable competitive Cox regression model was used to examine the association of depressive symptom trajectories with arthritis during follow-up. RESULTS Five depressive symptom trajectories were identified in our research: stable-high, decreasing, increasing, stable-moderate and stable-low. Compared with participants in the stable-low trajectory group, those in the stable-moderate, increasing, decreasing and stable-high trajectory groups had a higher cumulative risk of arthritis, with HRs (95% CIs) for arthritis of 1.64 (1.30, 2.07), 1.86 (1.30, 2.66), 1.99 (1.41, 2.80) and 2.19 (1.38, 3.48), respectively. Participants with the stable-high symptoms trajectory had the highest cumulative risk of arthritis. There was still a high risk of arthritis, although the depression state was reduced and remained at a level that is generally considered reasonable. CONCLUSIONS The higher depressive symptoms trajectories were significantly associated with the increased risk of arthritis, and the long-term depressive symptoms trajectories may be a strong predictor of having arthritis.
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Affiliation(s)
- Dingliu He
- Department of Clinical Nutrition, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, 224001, PR China
| | - Yayun Fan
- Department of Clinical Nutrition, Yancheng No.1 People's Hospital, Affiliated Hospital of Medical School, Nanjing University, Yancheng, 224001, PR China
| | - Yanan Qiao
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Siyuan Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, 199 Renai Road, Suzhou 215123, PR China
| | - Xiaowei Zheng
- Department of Public Health and Preventive Medicine, Wuxi School of Medicine Jiangnan University, 1800 Lihu Road, Binhu District, Wuxi, Jiangsu Province 214122, PR China.
| | - Juanjuan Zhu
- Department of Clinical Nutrition, Yancheng Third People's Hospital, The Sixth Affiliated Hospital of Nantong University, Yancheng, 224001, PR China.
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16
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Zhang W, Singh SP, Clement A, Calfee RP, Bijsterbosch JD, Cheng AL. Improvements in Physical Function and Pain Interference and Changes in Mental Health Among Patients Seeking Musculoskeletal Care. JAMA Netw Open 2023; 6:e2320520. [PMID: 37378984 PMCID: PMC10308248 DOI: 10.1001/jamanetworkopen.2023.20520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/23/2023] [Indexed: 06/29/2023] Open
Abstract
Importance Among patients seeking care for musculoskeletal conditions, there is mixed evidence regarding whether traditional, structure-based care is associated with improvement in patients' mental health. Objective To determine whether improvements in physical function and pain interference are associated with meaningful improvements in anxiety and depression symptoms among patients seeking musculoskeletal care. Design, Setting, and Participants This cohort study included adult patients treated by an orthopedic department of a tertiary care US academic medical center from June 22, 2015, to February 9, 2022. Eligible participants presented between 4 and 6 times during the study period for 1 or more musculoskeletal conditions and completed Patient-Reported Outcomes Measurement Information System (PROMIS) measures as standard care at each visit. Exposure PROMIS Physical Function and Pain Interference scores. Main Outcomes and Measures Linear mixed effects models were used to determine whether improvements in PROMIS Anxiety and PROMIS Depression scores were associated with improved PROMIS Physical Function or Pain Interference scores after controlling for age, gender, race, and PROMIS Depression (for the anxiety model) or PROMIS Anxiety (for the depression model). Clinically meaningful improvement was defined as 3.0 points or more for PROMIS Anxiety and 3.2 points or more for PROMIS Depression. Results Among 11 236 patients (mean [SD] age, 57 [16] years), 7218 (64.2%) were women; 120 (1.1%) were Asian, 1288 (11.5%) were Black, and 9706 (86.4%) were White. Improvements in physical function (β = -0.14; 95% CI, -0.15 to -0.13; P < .001) and pain interference (β = 0.26; 95% CI, 0.25 to 0.26; P < .001) were each associated with improved anxiety symptoms. To reach a clinically meaningful improvement in anxiety symptoms, an improvement of 21 PROMIS points or more (95% CI, 20-23 points) on Physical Function or 12 points or more (95% CI, 12-12 points) on Pain Interference would be required. Improvements in physical function (β = -0.05; 95% CI, -0.06 to -0.04; P < .001) and pain interference (β = 0.04; 95% CI, 0.04 to 0.05; P < .001) were not associated with meaningfully improved depression symptoms. Conclusions and Relevance In this cohort study, substantial improvements in physical function and pain interference were required for association with any clinically meaningful improvement in anxiety symptoms, and were not associated with any meaningful improvement in depression symptoms. Patients seeking musculoskeletal care clinicians providing treatment cannot assume that addressing physical health will result in improved symptoms of depression or potentially even sufficiently improved symptoms of anxiety.
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Affiliation(s)
- Wei Zhang
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Som P. Singh
- University of Missouri–Kansas City School of Medicine, Kansas City
| | - Amdiel Clement
- Washington University School of Medicine, St Louis, Missouri
| | - Ryan P. Calfee
- Division of Hand and Wrist, Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri
| | - Janine D. Bijsterbosch
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St Louis, Missouri
| | - Abby L. Cheng
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, St Louis, Missouri
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Cheng AL, Leo AJ, Calfee RP, Dy CJ, Armbrecht MA, Abraham J. Multi-stakeholder perspectives regarding preferred modalities for mental health intervention delivered in the orthopedic clinic: a qualitative analysis. BMC Psychiatry 2023; 23:347. [PMID: 37208668 DOI: 10.1186/s12888-023-04868-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 05/13/2023] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND Although depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders' perceptions regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care. METHODS This single-center, qualitative study was conducted within a tertiary care orthopedic department. Semi-structured interviews were conducted between January and May 2022. Two stakeholder groups were interviewed using a purposive sampling approach until thematic saturation was reached. The first group included adult orthopedic patients who presented for management of ≥ 3 months of neck or back pain. The second group included early, mid, and late career orthopedic clinicians and support staff members. Stakeholders' interview responses were analyzed using deductive and inductive coding approaches followed by thematic analysis. Patients also performed usability testing of one digital and one printed mental health intervention. RESULTS Patients included 30 adults out of 85 approached (mean (SD) age 59 [14] years, 21 (70%) women, 12 (40%) non-White). Clinical team stakeholders included 22 orthopedic clinicians and support staff members out of 25 approached (11 (50%) women, 6 (27%) non-White). Clinical team members perceived a digital mental health intervention to be feasible and scalable to implement, and many patients appreciated that the digital modality offered privacy, immediate access to resources, and the ability to engage during non-business hours. However, stakeholders also expressed that a printed mental health resource is still necessary to meet the needs of patients who prefer and/or can only engage with tangible, rather than digital, mental health resources. Many clinical team members expressed skepticism regarding the current feasibility of scalably incorporating in-person support from a mental health specialist into orthopedic care. CONCLUSIONS Although digital intervention offers implementation-related advantages over printed and in-person mental health interventions, a subset of often underserved patients will not currently be reached using exclusively digital intervention. Future research should work to identify combinations of effective mental health interventions that provide equitable access for orthopedic patients. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Abby L Cheng
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO, 63110, USA.
| | - Ashwin J Leo
- Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO, 63110, USA
| | - Ryan P Calfee
- Division of Hand and Wrist, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO, 63110, USA
| | - Christopher J Dy
- Division of Hand and Wrist, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO, 63110, USA
| | - Melissa A Armbrecht
- Division of Physical Medicine and Rehabilitation, Department of Orthopaedic Surgery, Washington University School of Medicine, Campus Box 8233, 660 South Euclid Avenue, St. Louis, MO, 63110, USA
| | - Joanna Abraham
- Department of Anesthesiology & Institute for Informatics, Washington University School of Medicine, 4990 Children's Place, St. Louis, MO, 63110, USA
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Cai J, Bidulescu A. The association between food insecurity and cognitive impairment among the US adults: The mediation role of anxiety or depression. J Affect Disord 2023; 325:73-82. [PMID: 36603601 DOI: 10.1016/j.jad.2022.12.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/08/2022] [Accepted: 12/18/2022] [Indexed: 01/03/2023]
Abstract
BACKGROUND Using a nationally representative sample, this study aimed to examine (1) socio-demographic and health-related disparities in cognitive impairment, (2) the association between food insecurity and cognitive impairment, and (3) the mediation role of anxiety or depression in the pathway between food insecurity and cognitive impairment. METHODS Cross-sectional data of 28,508 adults from the 2020 National Health Interview Survey were analyzed. Multivariable logistic regression models were used to estimate associations with cognitive impairment. Mediation analyses were conducted using the four-way decomposition method under a counterfactual framework. RESULTS Disparities in cognitive impairment were observed across socio-demographic and health-related characteristics (all p < 0.0001). Food insecurity was significantly associated with cognitive impairment in the overall population and the magnitude of the association was greater for the young or middle-aged, females and non-Hispanic Blacks than the general population (AOR ranged from 1.19 to 2.54, all p < 0.01). With anxiety as a mediator, 28.66 % of the total effect of food insecurity on cognitive impairment was attributable to mediation only, and 22.39 % was attributable to interaction (between food insecurity and anxiety) and mediation. With depression as a mediator, 22.33 % of the total effect was attributable to mediation only, and 16.00 % was attributable to interaction (between food insecurity and depression) and mediation. LIMITATIONS The cross-sectional design prevents inference of causality. CONCLUSIONS Ensuring available and adequate food resources is important to prevent adverse cognitive outcomes. Clinical interventions or treatments for anxiety or depression may help improve cognitive function.
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Affiliation(s)
- Jiahui Cai
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America.
| | - Aurelian Bidulescu
- Department of Epidemiology and Biostatistics, Indiana University Bloomington, Bloomington, IN, United States of America
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Zhang W, Singh SP, Clement A, Calfee RP, Bijsterbosch JD, Cheng AL. Relationships between improvement in physical function, pain interference, and mental health in musculoskeletal patients. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.12.23285824. [PMID: 36824736 PMCID: PMC9949185 DOI: 10.1101/2023.02.12.23285824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
Importance Among patients seeking care for musculoskeletal conditions, there is mixed evidence regarding whether traditional, structure-based care is associated with improvement in patients' mental health. Objective To determine whether improvements in physical function and pain interference are associated with meaningful improvements in anxiety and depression symptoms among patients seeking musculoskeletal care. Design Retrospective cohort study from June 22, 2015 to February 9, 2022. Setting Orthopedic department of a tertiary care US academic medical center. Participants Consecutive sample of adult patients who presented to the musculoskeletal clinic 4 to 6 times during the study period and completed Patient-Reported Outcomes Measurement Information System (PROMIS) measures as standard care at each visit. Exposure PROMIS Physical Function and Pain Interference scores. Main Outcomes and Measures Linear mixed effects models were used to determine whether: 1) PROMIS Anxiety and 2) PROMIS Depression scores improved as a function of improved PROMIS Physical Function or Pain Interference scores, after controlling for age, gender, race, and PROMIS Depression (for the Anxiety model) and PROMIS Anxiety (for the Depression model). Clinically meaningful improvement was defined as ≥3.0 points for PROMIS Anxiety and ≥3.2 points for PROMIS Depression. Results Among 11,236 patients (mean [SD] age 57 [16] years), 9,706 (86%) were White, and 7,218 (64%) were women. Improvements in physical function (β=-0.14 [95% CI -0.15- -0.13], p<0.001) and pain interference (β=0.26 [0.25-0.26], p<0.001) were each associated with improved anxiety symptoms. To reach a clinically meaningful improvement in anxiety symptoms, an improvement of ≥21 [20-23] PROMIS points on Physical Function or ≥12 [12-12] points on Pain Interference would be required. Improvements in physical function (β=-0.05 [- 0.06- -0.04], p<0.001) and pain interference (β=0.04 [0.04-0.05], p<0.001) were not associated with meaningfully improved depression symptoms. Conclusions and Relevance In this cohort study, substantial improvements in physical function and pain interference were required for association with any clinically meaningful improvement in anxiety symptoms and were not associated with any meaningful improvement in depression symptoms. Among patients seeking musculoskeletal care, musculoskeletal clinicians and patients cannot assume that addressing physical health will result in improved symptoms of depression or potentially even sufficiently improved symptoms of anxiety. Key Points Question: Among patients seeking musculoskeletal care, are improvements in physical function and pain interference associated with meaningful changes in symptoms of anxiety and depression?Findings: In this large cohort study, improvement by ≥2.3 population-level standard deviations (SD) on PROMIS Physical Function or ≥1.2 SD on PROMIS Pain Interference were required for any association with meaningful improvement in anxiety symptoms. Improvements in physical function and pain interference were not associated with meaningfully improved depression symptoms.Meaning: Musculoskeletal clinicians and patients cannot assume that exclusively addressing the physical aspect of a musculoskeletal condition will improve symptoms of depression or potentially even anxiety.
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20
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McConaghy K, Rullan P, Murray T, Molloy R, Heinberg LJ, Piuzzi NS. Team Approach: Management of Mental Health in Orthopaedic Patients. JBJS Rev 2023; 11:01874474-202302000-00003. [PMID: 36763707 DOI: 10.2106/jbjs.rvw.22.00167] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
» Mental health evaluation should be considered an essential part of the routine preoperative assessment and should be managed by a multidisciplinary team composed of the primary care physician, orthopaedic provider, and behavioral health specialist. » The scientific literature indicates that patients without comorbid psychiatric symptoms and adaptive coping strategies, resilience, and well-managed expectations have improved functional outcomes and satisfaction after orthopaedic procedures. » Psychological issues are multifaceted and require treatment tailored to each individual patient. Therefore, close communication between all members of the care team is required to create and execute the perioperative plan.
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Affiliation(s)
- Kara McConaghy
- Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Pedro Rullan
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Trevor Murray
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Robert Molloy
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio
| | - Leslie J Heinberg
- Department of Psychiatry and Psychology, Cleveland Clinic, Cleveland, Ohio
| | - Nicolas S Piuzzi
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, Ohio.,Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio.,Department of Orthopaedic Surgery, Cleveland Clinic, Cleveland, Ohio
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Saxena-Beem S, Dickson TA, Englund TR, Cleveland RJ, McCormick EM, Santana AE, Walker JA, Allen KD, Sheikh SZ. Perceived Impact of the COVID-19 Pandemic on Physical Activity Among Adult Patients With Rheumatologic Disease. ACR Open Rheumatol 2022; 4:1042-1049. [PMID: 36314195 DOI: 10.1002/acr2.11507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/24/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE The objective of this cross-sectional study was to investigate the impact of the COVID-19 pandemic on physical activity (PA) levels of patients with rheumatic and musculoskeletal diseases (RMDs) and to examine factors associated with decreased PA. METHODS A sample of adult patients with RMDs (n = 7,776) was identified through electronic medical records from an academic health care system in North Carolina. Invitations to participate in an online survey were sent between July 2020 and September 2020 to assess self-reported changes in PA during the COVID-19 pandemic. Descriptive statistics, age-adjusted prevalence odds ratios (PORs), and 95% confidence intervals (CIs) were computed to examine patient characteristics associated with decreased PA. RESULTS A total of 893 eligible participants completed the survey (mean age 57.8 ± 14.9 years, 75.8% female). The most common primary diagnoses reported among participants included rheumatoid arthritis (27.3%), osteoarthritis (16.0%), and systemic lupus erythematosus (SLE) (13.0%). More than half of participants (56.8%) reported engaging in less PA since the pandemic began. Factors associated with engaging in less PA included lower self-reported general health (POR, 2.21; CI, 1.64-2.97) and a diagnosis of SLE (POR, 1.57; CI, 1.03-2.38). Comorbidities associated with decreased PA included chronic pain (POR, 1.38; CI, 1.04-1.82), depression (POR, 1.48; CI, 1.09-2.01), and hypertension (POR, 1.44; CI, 1.10-1.90). CONCLUSION The COVID-19 pandemic has exacerbated barriers to PA in patients with RMDs. There is a critical need to provide resources, support, and multifaceted programs to encourage PA in patients with RMDs during the COVID-19 pandemic.
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Affiliation(s)
- Shruti Saxena-Beem
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Teresa A Dickson
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Tessa R Englund
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Rebecca J Cleveland
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Emily M McCormick
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Andres E Santana
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Julie A Walker
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA
| | - Kelli D Allen
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA.,Center of Innovation to Accelerate Discovery and Practice Transformation, Durham Veterans Affairs Health Care System, North Carolina, Durham, USA
| | - Saira Z Sheikh
- Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, North Carolina, Chapel Hill, USA.,Division of Rheumatology, Allergy, and Immunology, University of North Carolina at Chapel Hill Department of Medicine, North Carolina, Chapel Hill, USA
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22
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Abdellatif HM. Poor mental health days is associated with higher odds of poor oral health outcomes in the BRFSS 2020. BMC Oral Health 2022; 22:500. [DOI: 10.1186/s12903-022-02543-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/27/2022] [Indexed: 11/17/2022] Open
Abstract
Abstract
Background
To test the hypothesis that among individuals in the 2020 Behavioral Risk Factor Surveillance System (BRFSS) cross-sectional anonymous health survey in the United States (US), after controlling for confounding, an increasing number of poor mental health (MH) days in the past month is associated with increasing odds of delayed oral health (OH) care utilization and poorer OH outcomes.
Methods
Adjusted logistic regression models were developed with poor MH days as the exposure to examine the association with two dependent variables (DVs): Most recent dental visit longer than one year ago (yes/no), and having lost 6 or more teeth (yes/no).
Results
Approximately one third (32%) reported most recent dental visit more than one year ago, and 17% had lost 6 or more teeth. Those in the second quartile of poor MH days had 11% higher odds of delayed dental visit, and those in the highest quartile had 26% higher odds, compared to the reference group. For having lost 6 or more teeth, compared to the reference group, those in the third quartile had 8% higher odds and those in the fourth quartile had 18% higher odds.
Conclusions
Poor MH days is independently associated with odds of poor OH utilization and OH in the US above and beyond diagnosed mental and physical conditions. Policymakers in the US should expand health insurance plans to include dental insurance, and should increase access to MH care, especially for the aging population, and those with chronic conditions.
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23
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Handajani YS, Schröder-Butterfill E, Hogervorst E, Turana Y, Hengky A. Depression among Older Adults in Indonesia: Prevalence, Role of Chronic Conditions and Other Associated Factors. Clin Pract Epidemiol Ment Health 2022; 18:e174501792207010. [PMID: 37274861 PMCID: PMC10156049 DOI: 10.2174/17450179-v18-e2207010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/16/2022] [Accepted: 04/01/2022] [Indexed: 06/07/2023]
Abstract
Background Depression is one of the most common illnesses worldwide, with a prevalence of 5.7% among older adults aged over 60. Depression is a severe health condition that can significantly affect the quality of life. Objective The objective of this study is to investigate the determinant factors of depression among older adults in Indonesia. Methods Data of 4236 adults of 60 years old and over were taken from the fifth wave of the Indonesian Family Life Survey (IFLS-5). Sociodemographic and multiple health-related variables collected through interviews and measurements were analyzed. Multivariate logistic regression was used to evaluate depression and its associated factors. Results The prevalence of depression assessed using ten questions from the Center for Epidemiologic Studies Depression Scale (CES-D 10) was 16.3%. Significant associated factors for depression were moderate and low subjective economic status, living in Java or other regions outside Sumatra and Java, no life satisfaction, self-perceived as having poor health, having dependency (IADL scores), and experienced falls and insomnia. Among chronic conditions, stroke, arthritis, and hearing impairment were also more common in depressed older adults. Conclusion Predictors of depression identified in this study may be used to help prevent and improve depression in Indonesian older adults, especially those who live on Java. Improvement in healthcare, especially in the prevention and rehabilitation of stroke, arthritis, possible frailty (falls and dependency), hearing impairment, and insomnia, concurrent with early detection of depression in these chronic conditions, may help create a better quality of life among Indonesian older adults.
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Affiliation(s)
- Yvonne Suzy Handajani
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Eef Hogervorst
- School of Sport, Exercise & Health Sciences, Loughborough University, Loughborough, United Kingdom
| | - Yuda Turana
- School of Medicine and Health Science, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Antoninus Hengky
- Center of Health Research, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
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24
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Awad NB, Axon DR. Characteristics Associated with Good Self-Perceived Mental Health among United States Adults with Arthritis. Behav Sci (Basel) 2022; 12:bs12080256. [PMID: 36004827 PMCID: PMC9405205 DOI: 10.3390/bs12080256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 07/18/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
Mental health disorders are prevalent among United States (US) adults with arthritis. Yet, little is known about characteristics associated with mental health among US adults with arthritis. This retrospective cross-sectional study used 2019 Medical Expenditures Panel Survey data to assess the association between multiple personal characteristics and mental health status among US adults with arthritis. Hierarchical logistic regression models modeled associations between personal characteristics and mental health status. Model 1 included predisposing factors, model 2 included predisposing and enabling factors, while model 3 included predisposing, enabling, and need factors. The a priori alpha level was 0.05. Analyses accounted for the complex survey design and were weighted to produce national estimates. Among 28,512 individuals, 4984 met the inclusion criteria. Of these, 4181 had good mental health (85.5%, 95% confidence interval (CI) = 84.3%, 86.7%). The following characteristics were associated with good mental health status in the final adjusted model: age 18–64 vs. ≥65 (adjusted odds ratio (AOR) = 0.29, 95% CI = 0.12, 0.71), Midwest vs. West census region (AOR = 5.17, 95% CI = 1.63, 16.46), no degree vs. higher than high school education (AOR = 0.34, 95% CI = 0.12, 0.92), and high school diploma vs. higher than high school education (AOR = 0.40, 95% CI = 0.18, 0.86). In conclusion, this study suggests such characteristics may be targeted to help improve mental health among this population. Additional efforts are needed to help satisfy the unmet need for mental healthcare among this population.
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25
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Poole JL. Beyond the hand and upper extremity: The role of hand therapists in care of people with rheumatic diseases. J Hand Ther 2022; 35:339-345. [PMID: 35985938 DOI: 10.1016/j.jht.2022.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 06/23/2022] [Accepted: 07/03/2022] [Indexed: 02/03/2023]
Abstract
STUDY DESIGN Invited Clinical Commentary BACKGROUND: Arthritis is one of the most frequently reported causes of disability in the United States and the prevalence is expected to increase in the coming decades. While many rheumatic diseases involve hand impairments, most are systemic and involve more than the musculoskeletal system. Functional and work disability are high and people would benefit from the services of occupational and physical therapists. PURPOSE OF STUDY This paper reviews concepts of self-management, and symptoms that contribute to limitations and restrictions to participation in daily life in people with rheumatic diseases and suggests roles for hand therapists beyond the immediate hand impairments. METHODS The impact of selected rheumatic diseases on functional and work disability are reviewed along with strategies for symptom management and self-management. Upper extremity impairments of selected rheumatic diseases are also discussed. RESULTS The role for hand therapists in evaluating and addressing the complex needs of persons with rheumatic diseases, including less common diseases, is discussed. Outcome measures for fatigue, muscle involvement, ergonomics and computer use, and work disability are introduced. Finally, strategies for self-management and prevention of work and functional disability, along with symptom management for fatigue and pain are presented. CONCLUSION Hand therapists can play a vital role in chronic rheumatic disease management to improve self-management and increase participation in meaningful activities. Patients, primary care and rheumatology providers need to be educated about the scope of services occupational and physical therapists provide beyond the hand impairments.
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Affiliation(s)
- Janet L Poole
- Occupational Therapy Graduate Program, University of New Mexico, Albuquerque, NM, USA.
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26
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Pandrangi VC, Mace JC, Detwiller KY, Smith TL, Geltzeiler M. Financial Hardship Impacts Depression and Anxiety Among U.S. Patients with Sinusitis. Am J Rhinol Allergy 2022; 36:491-502. [PMID: 35234076 DOI: 10.1177/19458924221083383] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mental health conditions are common in the United States, and recent efforts have examined the development of mental health conditions among patients with sinusitis. OBJECTIVES The purpose of this study was to investigate the association between depression, anxiety, and financial hardship among patients with sinusitis. METHODS Cross-sectional study using the 2018 National Health Interview Survey (NHIS). Data regarding demographics, perceived financial hardship, self-reported depression and anxiety, mental healthcare utilization, and treatment compliance were obtained. RESULTS Among patients with sinusitis (N = 28 million adults), 9% reported depression and 24% reported anxiety. Sinusitis patients with depression and anxiety reported an increased severity of financial insecurity (p < 0.001). On multivariable logistic regression, worsening financial insecurity increased the odds of depression and anxiety. Patients reporting the highest financial insecurity severity had the highest odds of depression (OR = 3.88, 95% CI = 3.84-3.93, p < 0.001) and anxiety (OR = 2.09, 95% CI = 2.08-2.10, p < 0.001) among measures of financial stress. Specific financial stressors were independently associated with patient-reported depression and anxiety. Sinusitis patients with increased financial insecurity were more likely to require mental health services and treatment (p < 0.001), but were also more likely to report cost-related treatment noncompliance (p < 0.001) and reduced access to mental healthcare due to costs (p < 0.001). CONCLUSION Perceived financial hardship is associated with self-reported depression and anxiety among patients with sinusitis. Sinusitis patients with financial hardship also face challenges in accessing and maintaining mental health services and treatment due to costs. Understanding the burden of financial insecurity on mental health and access to treatment may improve quality of care through the development of screening tools and individualized treatment strategies.
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Affiliation(s)
- Vivek C Pandrangi
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Jess C Mace
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Kara Y Detwiller
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Timothy L Smith
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
| | - Mathew Geltzeiler
- Department of Otolaryngology-Head and Neck Surgery, Oregon Health & Science University, Portland, OR, USA
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27
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Amen TB, Chavez TJ, Dee EC, Varady NH, Yao JS, Paguio JA, Chen AF. Disparities in psychological distress and access to mental health services among immigrants with rheumatologic disease. Clin Rheumatol 2022; 41:2205-2211. [PMID: 35260950 DOI: 10.1007/s10067-022-06074-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/13/2022] [Accepted: 01/18/2022] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Patients with rheumatologic disease experience higher rates of comorbid mental health diseases than those without. Although mental health services (MHS) can improve musculoskeletal functional outcomes, access to MHS has been limited among vulnerable populations in the United States (US). The purpose of this study was to investigate contemporary patterns of severe psychological distress and receipt of MHS among immigrant populations with rheumatologic disease in the US. METHODS The National Health Interview Survey was queried for patients with rheumatologic disease from 2009 to 2018. Patient demographics, severe psychological distress, and receipt of MHS were collected and/or calculated. Multivariable logistic regressions assessed for factors associated with decreased receipt of MHS and severe psychological distress. RESULTS Immigrant patients with rheumatologic disease had higher rates of severe psychological distress than US-born patients (7.7% vs. 6.5%, p < 0.001), but were less likely to access MHS (8.3% vs. 11.0%, p < 0.001). Among immigrant patients, factors associated with lower MHS receipt included being Black (AOR 0.50, 95% CI 0.32-0.77, p = 0.002), Hispanic (AOR 0.80, 95% CI 0.30-1.00, p = 0.050), Asian (AOR 0.44, 95% CI 0.31-0.63, p < 0.001), older (p < 0.001), uninsured (p < 0.001), and having self-reported poor health (p < 0.001). DISCUSSION Immigrant patients with rheumatologic disease in the US had higher rates of severe psychological distress yet were less likely to receive MHS compared to US-born patients. Immigrants with rheumatologic illness were less likely to receive MHS if they were male, Black, Hispanic, Asian, older, lower income, or uninsured. This lack of MHS receipt may contribute to disparities in functional outcomes seen in immigrant minorities with musculoskeletal disease. Key Points • Immigrant patients with rheumatologic disease in the US had higher rates of severe psychological distress yet were less likely to receive MHS compared to US-born patients between 2009 and 2018 • Immigrants with rheumatologic illness were less likely to receive MHS if they were Black, Hispanic, Asian, older, lower income, or uninsured • Future efforts to carefully screen for mental health diseases in these vulnerable patient populations should be made while exploring patient-specific cultural considerations of MHS receipt.
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Affiliation(s)
- Troy B Amen
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., New York City, NY, 10021, USA.
| | - Tyler J Chavez
- Department of Orthopaedic Surgery, University of New Mexico, Albuquerque, NM, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, f1275 York Avenue, New York, NY, 10065, USA
| | - Nathan H Varady
- Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 E 70th St., New York City, NY, 10021, USA
| | - Jasper Seth Yao
- Department of Medicine, Albert Einstein Medical Center Philadelphia, 5501 Old York Rd., Philadelphia, PA, 19141, USA
| | - Joseph Alexander Paguio
- Department of Medicine, Albert Einstein Medical Center Philadelphia, 5501 Old York Rd., Philadelphia, PA, 19141, USA
| | - Antonia F Chen
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA, 02115, USA
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28
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Rethorn ZD, Rethorn TJ, Cook CE, Sharpe JA, Hastings SN, Allen KD. Association of Burden and Prevalence of Arthritis With Disparities in Social Risk Factors, Findings From 17 US States. Prev Chronic Dis 2022; 19:E08. [PMID: 35175917 PMCID: PMC8880108 DOI: 10.5888/pcd19.210277] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Social risks previously have been associated with arthritis prevalence and costs. Although social risks often cluster among individuals, no studies have examined associations between multiple social risks within the same individual. Our objective was to determine the association between individual and multiple social risks and the prevalence and burden of arthritis by using a representative sample of adults in 17 US states. Methods Data are from the 2017 Behavioral Risk Factor Surveillance System. Respondents were 136,432 adults. Social risk factors were food insecurity, housing insecurity, financial insecurity, unsafe neighborhoods, and health care access hardship. Weighted χ2 and logistic regression analyses, controlling for demographic characteristics, measures of socioeconomic position, and other health conditions examined differences in arthritis prevalence and burden by social risk factor and by a social risk index created by summing the social risk factors. Results We observed a gradient in the prevalence and burden of arthritis. Compared with those reporting 0 social risk factors, respondents reporting 4 or more social risk factors were more likely to have arthritis (adjusted odds ratio [AOR], 1.92; 95% CI, 1.57–2.36) and report limited usual activities (AOR, 2.97; 95% CI, 2.20–4.02), limited work (AOR, 2.72; 95% CI, 2.06–3.60), limited social activities (AOR, 3.10; 95% CI, 2.26–4.26), and severe joint pain (AOR, 1.86; 95% CI, 1.44–2.41). Conclusion Incremental increases in the number of social risk factors were independently associated with higher odds of arthritis and its burden. Intervention efforts should address the social context of US adults to improve health outcomes.
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Affiliation(s)
- Zachary D. Rethorn
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs Health Care System, Durham, North Carolina
| | - Timothy J. Rethorn
- School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, Ohio
| | - Chad E. Cook
- Doctor of Physical Therapy Division, Duke University School of Medicine, Durham, North Carolina
- Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina
- Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina
| | - Jason A. Sharpe
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs Health Care System, Durham, North Carolina
| | - S. Nicole Hastings
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs Health Care System, Durham, North Carolina
- Department of Population Health Sciences, Duke University Medical Center, Durham, North Carolina
- Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Geriatric Research, Education, and Clinical Center, Veterans Affairs Health Care System, Durham, North Carolina
- Center for the Study of Human Aging and Development, Duke University School of Medicine, Durham, North Carolina
| | - Kelli D. Allen
- Center of Innovation to Accelerate Discovery and Practice Transformation, Veterans Affairs Health Care System, Durham, North Carolina
- Department of Medicine and Thurston Arthritis Research Center, University of North Carolina, Chapel Hill, North Carolina
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29
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Wang ST, Ni GX. Depression in Osteoarthritis: Current Understanding. Neuropsychiatr Dis Treat 2022; 18:375-389. [PMID: 35237034 PMCID: PMC8883119 DOI: 10.2147/ndt.s346183] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/06/2022] [Indexed: 02/05/2023] Open
Abstract
Depression, one of the most common comorbidities with osteoarthritis (OA), affects patient prognosis and quality of life. It also increases the overall burden of disease. This subgroup of patients has not been effectively managed in clinical settings. The study aimed to direct physicians' attention to the co-occurrence of depression and OA. Therefore, this review summarizes the relevant literature published over the past 10 years. The focus is on the prevalence of and risk factors for depression in OA, the effects of depression on OA development and treatment response, comorbidity mechanisms, screening, and non-pharmacological treatment. The research on the etiology of depression has been driven largely by epidemiological studies. Recent studies have shown that high levels of pain, poor levels of function, high numbers of OA sites, and slow gait might be associated with depression. However, the pathophysiology of OA and depression comorbidities remains unclear. In addition to immune inflammation and structural changes in the brain, which have been documented in brain imaging studies, psychosocial factors may also play a role. The evidence indicates that depression can be treated with early intervention; however, adjustments may need to be made for individuals with comorbid depression in OA. It is recommended that health care providers pay more attention to depressive symptoms in patients with OA. Clinicians should develop and implement an individualized and comprehensive treatment plan for patients based on a mental health assessment and in teams with other professionals to optimize treatment outcomes.
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Affiliation(s)
- Shen-Tao Wang
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, People’s Republic of China
| | - Guo-Xin Ni
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, People’s Republic of China
- Correspondence: Guo-Xin Ni, Tel +86-10-62989780, Fax +86-10-62989670, Email
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30
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Mojtabai R, Amin-Esmaeili M. Validity of self-reports of medication treatment of depression in general population surveys. Pharmacoepidemiol Drug Saf 2021; 31:461-466. [PMID: 34907612 DOI: 10.1002/pds.5400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 11/09/2021] [Accepted: 12/12/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE To assess the concurrent validity of a single question on medication use for depression in a general population survey. METHODS Using data from 2015 to 2016 and 2017 to 2018 National Health and Nutrition Examination Survey, we compared responses to a single question on medication use for depression with responses to a detailed questionnaire confirmed by inspecting medication packages or pharmacy printouts. RESULTS There was a strong agreement (96.4%) between response to a single question about using medication for depression and responses to questions about using antidepressants or other psychiatric medications for depression on the detailed questionnaire. The single-question assessment had excellent sensitivity (93.8%) and specificity (96.7%), positive predictive value (71.5%), and kappa (0.79). Psychometric properties were mostly consistent across population subgroups. CONCLUSIONS Single-question assessments of medication use for depression have acceptable concurrent validity against more detailed assessments and provide an efficient method for assessing medication treatment of depression in population health surveys.
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Affiliation(s)
- Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Masoumeh Amin-Esmaeili
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.,Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
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31
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Eken HN, Dee EC, Powers AR, Jordan A. Racial and ethnic differences in perception of provider cultural competence among patients with depression and anxiety symptoms: a retrospective, population-based, cross-sectional analysis. Lancet Psychiatry 2021; 8:957-968. [PMID: 34563316 PMCID: PMC10688309 DOI: 10.1016/s2215-0366(21)00285-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/04/2021] [Accepted: 07/21/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Racial and ethnic minorities face disparities in access to health care. Culturally competent care might lessen these disparities. Few studies have studied the patients' view of providers' cultural competence, especially in psychiatric care. We aimed to examine the associations of race, ethnicity, and mental health status with patient-reported importance of provider cultural competence. METHODS Our retrospective, population-based, cross-sectional study used data extracted from self-reported questionnaires of adults aged at least 18 years who participated in the US National Health Interview Survey (NHIS; 2017 cycle). We included data on all respondents who answered supplementary cultural competence questions and the Adult Functioning and Disability survey within the NHIS. We classified participants as having anxiety or depression if they reported symptoms at least once a week or more often, and responded that the last time they had symptoms the intensity was "somewhere between a little and a lot" or "a lot." Participant answers to cultural competency survey questions (participant desire for providers to understand or share their culture, and frequency of access to providers who share their culture) were the outcome variables. Multivariable ordinal logistic regressions were used to estimate adjusted odds ratios (aORs) for the outcome variables in relation to sociodemographic characteristics (including race and ethnicity), self-reported health status, and presence of symptoms of depression, anxiety, or both. FINDINGS 3910 people had available data for analysis. Mean age was 52 years (IQR 36-64). 1422 (39·2%, sample weight adjusted) of the participants were men and 2488 (60·9%) were women. 3290 (82·7%) were White, 346 (9·1%) were Black or African American, 31 (0·8%) were American Indian or Alaskan Native, 144 (4·8%) were Asian American, and 99 (2·6%) were Mixed Race. 380 (12·5%) identified as Hispanic ethnicity and 3530 (87·5%) as non-Hispanic. Groups who were more likely to express a desire for their providers to share or understand their culture included participants who had depression symptoms (vs those without depression or anxiety symptoms, aOR 1·57 [95% CI 1·13-2·19], p=0·008) and participants who were of a racial minority group (Black vs White, aOR 2·54 [1·86-3·48], p=0·008; Asian American vs White, aOR 2·57 [1·66-3·99], p<0·001; and Mixed Race vs White, aOR 1·69 [1·01-2·82], p=0·045) or ethnic minority group (Hispanic vs non-Hispanic, aOR 2·69 [2·02-3·60], p<0·001); these groups were less likely to report frequently being able to see providers who shared their culture (patients with depression symptoms vs those without depression or anxiety symptoms, aOR 0·63 (0·41-0·96); p=0·030; Black vs White, aOR 0·56 [0·38-0·84], p=0·005; Asian American vs White, aOR 0·38 [0·20-0·72], p=0·003; Mixed Race vs White, aOR 0·35 [0·19-0·64], p=0·001; Hispanic vs non-Hispanic, aOR 0·61 [0·42-0·89], p=0·010). On subgroup analysis of participants reporting depression symptoms, patients who identified their race as Black or African American, or American Indian or Alaskan Native, and those who identified as Hispanic ethnicity, were more likely to report a desire for provider cultural competence. INTERPRETATION Racial and ethnic disparities exist in how patients perceive their providers' cultural competence, and disparities are pronounced in patients with depression. Developing a culturally competent and humble approach to care is crucial for mental health providers. FUNDING None.
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Affiliation(s)
- Hatice Nur Eken
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Ayana Jordan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA.
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Theis KA, Murphy LB, Guglielmo D, Boring MA, Okoro CA, Duca LM, Helmick CG. Prevalence of Arthritis and Arthritis-Attributable Activity Limitation - United States, 2016-2018. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2021; 70:1401-1407. [PMID: 34618800 PMCID: PMC8519273 DOI: 10.15585/mmwr.mm7040a2] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Arthritis has been the most frequently reported main cause of disability among U.S. adults for >15 years (1), was responsible for >$300 billion in arthritis-attributable direct and indirect annual costs in the U.S. during 2013 (2), is linked to disproportionately high levels of anxiety and depression (3), and is projected to increase 49% in prevalence from 2010-2012 to 2040 (4). To update national prevalence estimates for arthritis and arthritis-attributable activity limitation (AAAL) among U.S. adults, CDC analyzed combined National Health Interview Survey (NHIS) data from 2016-2018. An estimated 58.5 million adults aged ≥18 years (23.7%) reported arthritis; 25.7 million (10.4% overall; 43.9% among those with arthritis) reported AAAL. Prevalence of both arthritis and AAAL was highest among adults with physical limitations, few economic opportunities, and poor overall health. Arthritis was reported by more than one half of respondents aged ≥65 years (50.4%), adults who were unable to work or disabled* (52.3%), or adults with fair/poor self-rated health (51.2%), joint symptoms in the past 30 days (52.2%), activities of daily living (ADL)† disability (54.8%), or instrumental activities of daily living (IADL)§ disability (55.9%). More widespread dissemination of existing, evidence-based, community-delivered interventions, along with clinical coordination and attention to social determinants of health (e.g., improved social, economic, and mental health opportunities), can help reduce widespread arthritis prevalence and its adverse effects.
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Jin W, Liu Z, Zhang Y, Che Z, Gao M. The Effect of Individual Musculoskeletal Conditions on Depression: Updated Insights From an Irish Longitudinal Study on Aging. Front Med (Lausanne) 2021; 8:697649. [PMID: 34513871 PMCID: PMC8426633 DOI: 10.3389/fmed.2021.697649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 07/30/2021] [Indexed: 11/26/2022] Open
Abstract
Few longitudinal studies have systematically investigated whether or how individual musculoskeletal conditions (IMCs) convey risks for negative psychological health outcomes, and approaches to assess such risk in the older population are lacking. In this Irish nationally representative longitudinal prospective study of 6,715 individuals aged 50 and above, machine learning algorithms and various models, including mediation models, were employed to elaborate the underlying mechanisms of IMCs leading to depression and to develop an IMC-induced negative psychological risk (IMCPR) classification approach. Resultantly, arthritis [odds ratio (95% confidence interval): 2.233 (1.700-2.927)], osteoporosis [1.681 (1.133-2.421)], and musculoskeletal chronic pain [MCP, 2.404 (1.838-3.151)] were found to increase the risk of depression after 2 years, while fracture and joint replacement did not. Interestingly, mediation models further demonstrated that arthritis per se did not increase the risk of depression; such risk was augmented only when arthritis-induced restrictions of activities (ARA) existed [proportion of mediation: 316.3% (ARA of usual), 213.3% (ARA of social and leisure), and 251.3% (ARA of sleep)]. The random forest algorithm attested that osteoarthritis, not rheumatoid arthritis, contributed the most to depressive symptoms. Moreover, bone mineral density was negatively associated with depressive symptoms. Systemic pain contributed the most to the increased risk of depression, followed by back, knee, hip, and foot pain (mean Gini-Index: 3.778, 2.442, 1.980, 1.438, and 0.879, respectively). Based on the aforementioned findings, the IMCPR classification approach was developed using an interpretable machine learning model, which stratifies participants into three grades. Among the IMCPR grades, patients with a grade of "severe" had higher odds of depression than those with a "mild" [odds ratio (95% confidence interval): 4.055 (2.907-5.498)] or "moderate" [3.584 (2.101-5.883)] grade. Females with a "severe" grade had higher odds of depression by 334.0% relative to those with a "mild" grade, while males had a relative risk of 258.4%. In conclusion, the present data provide systematic insights into the IMC-induced depression risk and updated the related clinical knowledge. Furthermore, the IMCPR classification approach could be used as an effective tool to evaluate this risk.
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Affiliation(s)
- Wenyi Jin
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zilin Liu
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yubiao Zhang
- Department of Orthopedics, Renmin Hospital of Wuhan University, Wuhan, China
| | - Zhifei Che
- Department of Urology, The First Affiliated Hospital of Hainan Medical University, Haikou, China
| | - Mingyong Gao
- Department of Orthopedics, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, China
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D'Aiuto C, Gamm S, Grenier S, Vasiliadis HM. The association between chronic pain conditions and subclinical and clinical anxiety among community-dwelling older adults consulting in primary care. PAIN MEDICINE 2021; 23:1118-1126. [PMID: 34260733 DOI: 10.1093/pm/pnab213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To examine associations between chronic pain conditions, pain level, and subclinical/clinical anxiety in community-dwelling older adults. DESIGN Cross-sectional associations were analyzed using multinomial logistic regression to compare the odds of having subclinical/clinical anxiety by painful condition and pain level, controlling for confounders. SETTING Participants were recruited in primary care waiting rooms to take part in the first wave of the Étude sur la Santé des Aînés (ESA)-Services study. SUBJECTS 1608 older adults aged 65+. METHODS Clinical anxiety was assessed using DSM-IV criteria. Subclinical anxiety was considered present when participants endorsed symptoms of anxiety but did not fulfill clinical diagnostic criteria for an anxiety disorder. Painful chronic conditions included arthritis, musculoskeletal conditions, gastrointestinal problems, and headaches/migraines. Presence of painful conditions was assessed using combined self-report and health administrative data sources. Pain level was self-reported on an ordinal scale. Physical comorbidities were identified from ICD-9/10 diagnostic codes and depression was evaluated based on the DSM-IV. RESULTS Sixty-six percent of home-living older adults suffer from a chronic pain condition. Older adults with clinical anxiety are more likely to experience musculoskeletal pain, gastrointestinal problems, headaches/migraines, and higher pain levels compared to those with no anxiety. Also, those with ≥3 painful conditions are at greater risk for subclinical and clinical anxiety compared to those with no painful condition. CONCLUSIONS These results emphasize the need for assessing anxiety symptoms in older adults with chronic pain conditions. Comprehensive management of comorbid chronic pain and psychopathology might help reduce the burden for patients and the healthcare system.
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Affiliation(s)
- Carina D'Aiuto
- Faculty of Medicine and Health Sciences, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Quebec, Canada J4K 0A8.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les Innovations en Santé, 150 Place Charles-Le Moyne, Longueuil, Quebec, Canada J4K 0A8
| | - Simone Gamm
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, Quebec, Canada H3W 1W5.,Department of Psychology, Université de Montréal, 90 Vincent D'Indy Ave, Montreal, Quebec, Canada H2V 2S9
| | - Sébastien Grenier
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, 4565 Queen Mary Rd, Montreal, Quebec, Canada H3W 1W5.,Department of Psychology, Université de Montréal, 90 Vincent D'Indy Ave, Montreal, Quebec, Canada H2V 2S9
| | - Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Quebec, Canada J4K 0A8.,Centre de recherche Charles-Le Moyne - Saguenay-Lac-Saint-Jean sur les Innovations en Santé, 150 Place Charles-Le Moyne, Longueuil, Quebec, Canada J4K 0A8
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Huffman KF, Thornhill TH, Ambrose KR, Nelson AE, Callahan LF. Osteoarthritis and Its Management. PHYSICIAN ASSISTANT CLINICS 2021. [DOI: 10.1016/j.cpha.2020.08.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Jetha A, Theis KA, Boring MA, Murphy LB, Guglielmo D. Depressive Symptoms and the Arthritis-Employment Interface: A Population-Level Study. Arthritis Care Res (Hoboken) 2021; 73:65-77. [PMID: 32702187 PMCID: PMC10481427 DOI: 10.1002/acr.24381] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 07/09/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To examine the relationship between depressive symptoms, arthritis, and employment, and to determine whether this relationship differs across young, middle-age, and older working-age adults with arthritis. METHODS Data from the US National Health Interview Survey from 2013-2017 were analyzed. Analyses were restricted to adults with doctor-diagnosed arthritis of working age (ages 18-64 years) with complete data on depressive symptoms (n = 11,380). Covariates were sociodemographic information, health, and health system utilization variables. Employment prevalence was compared by self-reported depressive symptoms. We estimated percentages, as well as univariable and multivariable logistic regression models, to examine the relationship between depression and employment among young adults (ages 18-34 years), middle-age adults (ages 35-54 years), and older adults (ages 55-64 years). RESULTS Among all working-age US adults with arthritis, the prevalence of depressive symptoms was 13%. Those reporting depressive symptoms had a higher prevalence of fair/worse health (60%) and arthritis-attributable activity limitations (70%) compared to those not reporting depression (23% and 39%, respectively). Respondents with depressive symptoms reported significantly lower employment prevalence (30%) when compared to those not reporting depressive symptoms (66%) and lower multivariable-adjusted association with employment (prevalence ratio 0.88 [95% confidence interval (95% CI) 0.83-0.93]). Middle-age adults reporting depression were significantly less likely to be employed compared to their counterparts without depression (prevalence ratio 0.83 [95% CI 0.77-0.90]); similar but borderline statistically significant relationships were observed for both young adults (prevalence ratio 0.86 [95% CI 0.74-0.99]) and older adults (prevalence ratio 0.94 [95% CI 0.86-1.03]). CONCLUSION For adults with arthritis, depressive symptoms are associated with not participating in employment. Strategies to reduce arthritis-related work disability may be more effective if they simultaneously address mental health.
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Affiliation(s)
- Arif Jetha
- Institute for Work and Health, and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | | | | | - Dana Guglielmo
- Centers for Disease Control and Prevention, Atlanta, Georgia, and Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
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Ellis KR, Hecht HK, Young TL, Oh S, Thomas S, Hoggard LS, Ali Z, Olawale R, Carthron D, Corbie-Smith G, Eng E. Chronic Disease Among African American Families: A Systematic Scoping Review. Prev Chronic Dis 2020; 17:E167. [PMID: 33416471 PMCID: PMC7784550 DOI: 10.5888/pcd17.190431] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Chronic diseases are common among African Americans, but the extent to which research has focused on addressing chronic diseases across multiple members of African American families is unclear. This systematic scoping review summarizes the characteristics of research addressing coexisting chronic conditions among African American families, including guiding theories, conditions studied, types of relationships, study outcomes, and intervention research. METHODS The literature search was conducted in PsycInfo, PubMed, Social Work Abstracts, Sociological Abstracts, CINAHL, and Family and Society Studies Worldwide to identify relevant articles published from January 2000 through September 2016. We screened the title and abstracts of 9,170 articles, followed by full-text screening of 530 articles, resulting in a final sample of 114 articles. Fifty-seven percent (n = 65) of the articles cited a guiding theory/framework, with psychological theories (eg, social cognitive theory, transtheoretical model) being most prominent. The most common conditions studied in families were depression (70.2%), anxiety (23.7%), and diabetes (22.8%), with most articles focusing on a combination of physical and mental health conditions (47.4%). RESULTS In the 114 studies in this review, adult family members were primarily the index person (71.1%, n = 81). The index condition, when identified (79.8%, n = 91), was more likely to be a physical health condition (46.5%, n = 53) than a mental health condition (29.8%, n = 34). Among 343 family relationships examined, immediate family relationships were overwhelmingly represented (85.4%, n = 293); however, extended family (12.0%, n = 41) and fictive kin (0.6%, n = 2) were included. Most (57.0%, n = 65) studies focused on a single category of outcomes, such as physical health (eg, obesity, glycemic control), mental health (eg, depression, anxiety, distress), psychosocial outcomes (eg, social support, caregiver burden), or health behaviors (eg, medication adherence, disease management, health care utilization); however, 43.0% (n = 49) of studies focused on outcomes across multiple categories. Sixteen intervention articles (14.0%) were identified, with depression the most common condition of interest. CONCLUSION Recognizing the multiple, simultaneous health issues facing families through a lens of family comorbidity and family multimorbidity may more accurately mirror the lived experiences of many African American families and better elucidate intervention opportunities than previous approaches.
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Affiliation(s)
- Katrina R Ellis
- University of Michigan, School of Social Work, Room 3849, Ann Arbor, MI 48109.
| | - Hillary K Hecht
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Policy and Management, Chapel Hill, North Carolina
| | - Tiffany L Young
- University of North Carolina at Chapel Hill, North Carolina Translational Research and Clinical Sciences Institute, Chapel Hill, North Carolina
- Lenell and Lillie Consulting, LLC, New Bern, North Carolina
| | - Seyoung Oh
- University of Michigan, School of Social Work, Ann Arbor, Michigan
| | - Shikira Thomas
- University of North Carolina at Chapel Hill, Cecil G. Sheps Center for Health Services Research, Chapel Hill, North Carolina
| | - Lori S Hoggard
- Rutgers University-New Brunswick, Department of Psychology, New Brunswick, New Jersey
| | - Zaire Ali
- Rutgers University-New Brunswick, Department of Psychology, New Brunswick, New Jersey
| | - Ronke Olawale
- University of Michigan, School of Social Work, Ann Arbor, Michigan
| | - Dana Carthron
- North Carolina Central University, College of Behavioral Sciences, Durham, North Carolina
| | - Giselle Corbie-Smith
- University of North Carolina at Chapel Hill, School of Medicine, Department of Social Medicine, Chapel Hill, North Carolina
| | - Eugenia Eng
- University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Department of Health Behavior, Chapel Hill, North Carolina
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Psychiatric Comorbidity in Patients With Chronic Pancreatitis Associates With Pain and Reduced Quality of Life. Am J Gastroenterol 2020; 115:2077-2085. [PMID: 32740078 DOI: 10.14309/ajg.0000000000000782] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Abdominal pain, frequent in patients with chronic pancreatitis (CP), has a negative impact on quality of life (QOL). Psychiatric comorbidities including anxiety and depression are associated with pain, but their prevalence and effects on QOL in CP have not been quantified. We studied the prevalence of anxiety and depression in patients with CP and their associated patient and disease characteristics and impact on QOL. METHODS This was a cross-sectional, multicenter prospective study. Patients were screened with the Hospital Anxiety and Depression Scale questionnaire. A Hospital Anxiety and Depression Scale score >7 on the respective anxiety or depression subscales indicated the presence of anxiety or depression and was used as a surrogate for the diagnosis of psychiatric comorbidities. Patient demographics, disease characteristics, QOL (EORTC-QLQ-C30), and pain symptoms (Brief Pain Inventory Short Form) were compared between patients with and without psychiatric comorbidities. RESULTS One hundred seventy-one patients with CP (mean age 53.8 ± 13.7 years, 60% men) were included. Anxiety and depression were present in 80 (46.8%) and 66 (38.6%) patients, with overlap in 50 (29%). Patients with anxiety or depression reported higher pain prevalence, pain severity, and pain interference scores (all P < 0.001). Psychiatric comorbidities also associated with reduced global health scores and functional subscales (all P < 0.001) and higher symptom burden (P ≤ 0.03). An independent association was noted between global health status and depression (P < 0.001). DISCUSSION Psychiatric comorbidities are prevalent in patients with CP and associated with pain and QOL. Where the effect of anxiety on QOL may be mediated via pain, depression is independently related to QOL. These findings warrant consideration in the management of patients with CP.
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Lenhard NK, Sullivan JK, Ross EL, Song S, Edwards RR, Hunter DJ, Neogi T, Katz JN, Losina E. Does screening for depressive symptoms help optimize duloxetine use in knee OA patients with moderate pain? A cost-effectiveness analysis. Arthritis Care Res (Hoboken) 2020; 74:776-789. [PMID: 33253496 PMCID: PMC8164641 DOI: 10.1002/acr.24519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 01/18/2021] [Accepted: 11/24/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Duloxetine is an FDA-approved treatment for both osteoarthritis (OA) pain and depression, but uptake of duloxetine in knee OA management varies. We examined the cost-effectiveness of adding duloxetine to knee OA care with or without depression screening. METHODS We used the Osteoarthritis Policy Model, a validated computer microsimulation of knee OA, to examine the value of duloxetine for knee OA patients with moderate pain by comparing three strategies: 1) usual care (UC); 2) duloxetine for those who screen positive for depression on the Patient Health Questionnaire 9 (PHQ-9) + UC; and 3) universal duloxetine + UC. Outcomes included quality-adjusted life years (QALYs), lifetime direct medical costs, and incremental cost-effectiveness ratios (ICERs), discounted at 3% annually. Model inputs, drawn from published literature and national databases, included: annual cost of duloxetine, $721-$937; average pain reduction for duloxetine, 17.5 points on the WOMAC pain scale (0-100); likelihood of depression remission with duloxetine, 27.4%. We considered two willingness-to-pay (WTP) thresholds of $50,000/QALY and $100,000/QALY. We varied parameters related to the PHQ-9 and duloxetine's cost, efficacy, and toxicities to address uncertainty in model inputs. RESULTS The screening strategy led to an additional 17 QALYs per 1,000 subjects and increased costs by $289/subject (ICER=$17,000/QALY). Universal duloxetine led to an additional 31 QALYs per 1,000 subjects and $1,205/subject (ICER=$39,300/QALY). Under the majority of sensitivity analyses, universal duloxetine was cost-effective at the $100,000/QALY threshold. CONCLUSION Adding duloxetine to usual care for knee OA patients with moderate pain, regardless of depressive symptoms, is cost-effective at frequently-used WTP thresholds.
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Affiliation(s)
- Nora K Lenhard
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - James K Sullivan
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Eric L Ross
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA.,Department of Psychiatry, McLean Hospital, Belmont, MA, 02478, USA.,Harvard Medical School, Harvard University, Boston, MA, 02115, USA
| | - Shuang Song
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Robert R Edwards
- Department of Anesthesiology, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - David J Hunter
- Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Rheumatology Department, Royal North Shore Hospital, Sydney, Australia
| | - Tuhina Neogi
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Jeffrey N Katz
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery Brigham and Women's Hospital, Boston, MA, 02115, USA.,Harvard Medical School, Harvard University, Boston, MA, 02115, USA.,Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, 02115, USA
| | - Elena Losina
- Orthopaedic and Arthritis Center for Outcomes Research (OrACORe) and Policy and Innovation eValuation in Orthopaedic Treatments (PIVOT) Center, Department of Orthopaedic Surgery Brigham and Women's Hospital, Boston, MA, 02115, USA.,Harvard Medical School, Harvard University, Boston, MA, 02115, USA.,Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, MA, 02115, USA.,Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
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Chen J, Hu F, Yang BX, Cai Y, Cong X. Experience of living with pain among older adults with arthritis: A systematic review and meta-synthesis. Int J Nurs Stud 2020; 111:103756. [PMID: 32927408 DOI: 10.1016/j.ijnurstu.2020.103756] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/09/2020] [Accepted: 08/14/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Millions of people older than 60 years are affected by arthritis. Unrelieved chronic pain of arthritis is associated with increased healthcare needs and decreased quality of life in older adults. Understanding older adults' perceptions and experiences of living with arthritis pain can benefit healthcare experts in designing and implementing clinical, education, and research programs to better care for this population. OBJECTIVES This meta-synthesis of qualitative studies aimed to explore older adults' experiences of living with arthritis pain. DESIGN A narrative meta-synthesis. DATA SOURCES/REVIEW METHOD Journal articles published in English were identified by conducting electronic searches in CINAHL, PubMed, PsycINFO, Scopus, and ISI Web of Science to June 2019. Unpublished studies were searched in Google Scholar, ProQuest Dissertations and Theses Database. Four groups of keywords were combined in the search strategy: (1) research methods/qualitative researches; (2) older adults; (3) arthritis/arthritis pain; (4) experience. Studies were included if they (a) used qualitative research designs, qualitative data collection and analysis; (b) included participants aged 60 years and older regardless of the study context; (c) reported on older adults' experiences of living with arthritis pain; and (d) were published in English. Studies were excluded if: (a) they used mixed methods where qualitative data could not be extracted or (b) the data analysis lacked the necessary qualitative depth. Noblit and Hare's methodology of synthesizing qualitative studies was used. RESULTS Eleven studies were included. Among the 11 included studies published in 2003-2018, the sample size ranged from 3 to 551 participants. Older adults aged 62 to 95 years, and the majority were female. The ethnicity of the older adults was reported in 7 studies, including Caucasians, African Americans, Hispanics, Korean Americans, Australian, European, and South Korean. Through meta-synthesis, four themes were identified. The lived experiences of pain among older adults with arthritis include the center of daily living, a lonely path, an inevitable and endless process, and surviving through pain management. CONCLUSIONS These themes may reflect older adults' experiences of living with arthritis pain across diverse ethnicities and cultures. Health care providers must be sensitive to older adults' experience of arthritis pain, realize the importance of providers' support on patients' adaptation, and provide comprehensive and individualized patient-centered interventions for managing arthritis pain for older adults. The study protocol had been registered in PROSPERO (International prospective register of systematic reviews). The registration number is CRD42019129716. Link: http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42019129716.
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Affiliation(s)
- Jie Chen
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT 06269-4026, United States.
| | - Fen Hu
- Nursing Department, Zhongnan Hospital of Wuhan University, No. 169 Donghu Road, Wuchang District, Wuhan 430071, China.
| | - Bing Xiang Yang
- Wuhan University School of Health Sciences, No. 115 Donghu Road, Wuchang District, Wuhan 430071, China.
| | - Yi Cai
- Wuhan University School of Health Sciences, No. 115 Donghu Road, Wuchang District, Wuhan 430071, China.
| | - Xiaomei Cong
- University of Connecticut School of Nursing, 231 Glenbrook Road, Storrs, CT 06269-4026, United States.
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Murphy LB, Cisternas MG, Theis KA, Brady TJ, Bohm MK, Guglielmo D, Hootman JM, Barbour KE, Boring MA, Helmick CG. All-Cause Opioid Prescriptions Dispensed: The Outsized Role of Adults With Arthritis. Am J Prev Med 2020; 59:355-366. [PMID: 32763134 DOI: 10.1016/j.amepre.2020.03.028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 02/28/2020] [Accepted: 03/16/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Limited estimates of prescribed opioid use among adults with arthritis exist. All-cause (i.e., for any condition) prescribed opioid dispensed (referred to as opioid prescription in the remainder of this abstract) in the past 12 months among U.S. adults aged ≥18 years (n=35,427) were studied, focusing on adults with arthritis (n=12,875). METHODS In 2018-2019, estimates were generated using Medical Expenditure Panel Survey data: (1) 2015 prevalence of 1 or more opioid prescriptions to U.S. adults overall and by arthritis status and (2) in 2014-2015, among adults with arthritis, multivariable-adjusted associations between 1 or more opioid prescriptions and sociodemographic characteristics, health status, and healthcare utilization characteristics. RESULTS In 2015, the age-standardized prevalence of 1 or more opioid prescriptions among adults with arthritis (29.6%) was almost double of that for all adults (15.4%). Adults with arthritis represented more than half of all adults (55.3%) with at least 1 opioid prescription; among those with 1 or more prescriptions, 43.2% adults had 4 or more prescriptions. The strongest multivariable-adjusted associations with 1 or more opioid prescriptions were ambulatory care visits (1-4: prevalence ratios=1.9-2.0, 5-8: prevalence ratios=2.5-2.7, 9 or more: prevalence ratios=3.4-3.7) and emergency room visits (1: prevalence ratios=1.6, 2-3: prevalence ratios=1.9-2.0, 4 or more: prevalence ratios=2.4); Ref for both: no visits. CONCLUSIONS Adults with arthritis are a high-need target group for improving pain management, representing more than half of all U.S. adults with 1 or more opioid prescriptions. The association with ambulatory care visits suggests that providers have routine opportunities to discuss comprehensive and integrative pain management strategies, including low-cost evidence-based self-management approaches (e.g., physical activity, self-management education programs, cognitive behavioral therapy). Those with multiple opioid prescriptions may need extra support if transitioning to nonopioid and nonpharmacologic pain management strategies.
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Affiliation(s)
- Louise B Murphy
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia.
| | | | - Kristina A Theis
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Teresa J Brady
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Clarity Consulting and Communications, Atlanta, Georgia
| | - Michele K Bohm
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Dana Guglielmo
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Jennifer M Hootman
- Retired, Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kamil E Barbour
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Charles G Helmick
- Division of Population Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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Yang R, Wang J, Wang H, Tracy EL, Tracy CT. A cross-lagged model of depressive symptoms and mobility disability among middle-aged and older Chinese adults with arthritis. Geriatr Gerontol Int 2020; 20:873-877. [PMID: 32827228 DOI: 10.1111/ggi.13993] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 06/15/2020] [Accepted: 07/02/2020] [Indexed: 12/27/2022]
Abstract
AIM To examine the reciprocal and longitudinal associations between depressive symptoms and mobility disability in middle-aged and older Chinese adults with arthritis. METHODS We used three waves of the China Health and Retirement Longitudinal Study. The analytic sample included 4682 community-dwelling adults aged ≥45 years with arthritis who completed the self-report measurement of depressive symptoms and mobility disability every 2 years over a 4-year study period. Analysis involved an autoregressive cross-lagged model. RESULTS The prevalence rates of comorbid depressive symptoms and mobility disability were 38.9%, 33.2% and 38.9%, respectively across three waves. There was a significant bidirectional and longitudinal relationship between depressive symptoms and mobility disability among middle-aged and older Chinese adults with arthritis. A higher level of depressive symptoms in previous waves was associated with a subsequent increase in mobility disability over time. A similar pattern was also shown in the opposite direction from mobility disability to depressive symptoms over time. CONCLUSIONS This study demonstrates that depressive symptoms and mobility disability are reciprocally related in Chinese adults with arthritis over time. In addition, it highlights the importance of early interventions aimed at reversing the downward spiral of depressive symptoms and mobility disability to improve the health of Chinese adults with arthritis. Geriatr Gerontol Int 2020; 20: 873-877.
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Affiliation(s)
- Rumei Yang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Jingxia Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Haocen Wang
- Department of Health and Kinesiology, Texas A&M University, College Station, Texas, USA
| | - Eunjin Lee Tracy
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Cory T Tracy
- Independent Researcher, Salt Lake City, Utah, USA
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Marks R. Anxiety and Osteoarthritis Disability: Updated Overview and Commentary. Open Orthop J 2020. [DOI: 10.2174/1874325002014010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
Introduction:
Osteoarthritis, a widespread highly painful often incapacitating joint disease continues to impose immense personal and societal challenges among adults of all ages, especially among older adults. In the absence of any effective cure or treatment, it has become essential to explore all correlates of this chronic disabling disease, especially those that might be preventable or modifiable. Anxiety, a potentially remediable state of mental distress - found linked to chronically disabling forms of arthritis, in various imperceptible ways, and which may have an immense bearing on the outcomes of osteoarthritis, has not received as much attention in the related literature as other topics, such as surgery.
Objective:
In line with previous promising work, this narrative review elected to explore the extent to which current researchers in the field are pursuing this topic, and if so, the degree to which prevailing peer-reviewed data sources support an important role for continued research in this realm, and in what regard.
Methods:
Primarily explored were the key databases housing relevant publications that emerged over Aug 1, 2018-Feb 26, 2020 using the keywords Osteoarthritis and Anxiety. Using a descriptive approach, the relative progress made over the past five previous years in this regard was assessed, in addition to what joints have been studied and with what frequency, and how the degree of interest compares to other currently researched osteoarthritis themes. The potential for intervening in the osteoarthritis pain cycle by addressing anxiety was also examined.
Results:
Findings show a high level of current interest in this topic, and that despite the paucity of prospective studies, studies on joints other than the knee and hip joints, some equivocal conclusions, small numbers of anxiety-related studies compared to other topics, and substantive design limitations, it appears that future research in this realm is strongly indicated.
Conclusion:
This topic if examined further is likely to produce highly advantageous results at all stages of the osteoarthritic disease process and in the context of primary, secondary, as well as tertiary measures to ameliorate osteoarthritis pain and disability.
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Price JD, Barbour KE, Liu Y, Lu H, Amerson NL, Murphy LB, Helmick CG, Calanan RM, Sandoval-Rosario M, Samanic CM, Greenlund KJ, Thomas CW. State-Specific Prevalence and Characteristics of Frequent Mental Distress and History of Depression Diagnosis Among Adults with Arthritis - United States, 2017. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2020; 68:1173-1178. [PMID: 31895918 PMCID: PMC6943969 DOI: 10.15585/mmwr.mm685152a1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Theis KA, Brady TJ, Helmick CG, Murphy LB, Barbour KE. Associations of Arthritis-Attributable Interference with Routine Life Activities: A Modifiable Source of Compromised Quality-of-Life. ACR Open Rheumatol 2019; 1:412-423. [PMID: 31777821 PMCID: PMC6857987 DOI: 10.1002/acr2.11050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 06/17/2019] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Arthritis patients experience the impact of disease beyond routinely assessed clinical measures. We characterized arthritis-attributable interference in four important routine life domains: 1) recreation/leisure/hobbies; 2) household chores; 3) errands/shopping; and 4) social activities. METHODS Participants were from the Arthritis Conditions Health Effects Survey (2005-2006), a cross-sectional survey of noninstitutionalized US adults 45 years or older with doctor-diagnosed arthritis (n = 1793). We estimated the prevalence of "a lot" of arthritis-attributable interference and quantified the associations between sociodemographic, clinical, and psychological characteristics and "a lot" of arthritis-attributable interference (vs "a little" or "none") in each domain using prevalence ratios (PRs) in multivariable (MV)-adjusted logistic regression models. RESULTS An estimated 1 in 5 to 1 in 4 adults with arthritis reported "a lot" of arthritis-attributable interference in recreation/leisure/hobbies (27%), household chores (25%), errands/shopping (22%), and social activities (18%). The highest prevalence of "a lot" of arthritis-attributable interference was for those unable to work/disabled or reporting severe arthritis symptoms (pain, stiffness, fatigue), anxiety, depression, or no/low confidence in ability to manage arthritis, across domains. In MV-adjusted models, those unable to work/disabled, currently seeing a doctor, or reporting fair/poor self-rated health, severe joint pain, anxiety, or no/low confidence in ability to manage arthritis were more likely to report arthritis-attributable interference than their respective counterparts. Magnitudes varied by domain but were consistently strongest for those unable to work/disabled (MV PR range = 1.8-2.5) and with fair/poor health (MV PR range = 1.7-2.7). CONCLUSION Many characteristics associated with arthritis-attributable interference in routine life activities are potentially modifiable, suggesting unmet need for use of existing evidence-based interventions that address these characteristics and reduce interferences to improve quality of life.
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Affiliation(s)
- K. A. Theis
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGA
| | - T. J. Brady
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGA
| | - C. G. Helmick
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGA
| | - L. B. Murphy
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGA
| | - K. E. Barbour
- National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and PreventionAtlantaGA
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Abstract
PURPOSE OF REVIEW To review recent studies which assess comorbidity, that is, prevalence of co-occurrence, relationships and treatment implications between anxiety disorders and various medical illnesses. RECENT FINDINGS The prevalence rates of anxiety disorders in patients with medical illnesses are high, with percentage up to 29% in patients with epilepsy, 48.9% in patients with multiple sclerosis, 30.1% in patients with Parkinson's disease, 30% in patients with cardiovascular disease, 47.0% in patients with diabetes mellitus, and so on. The most prevalent anxiety disorders among individuals with somatic illnesses are generalized anxiety disorder and panic disorder. In addition, various medical illnesses are highly prevalent in samples of patients with anxiety disorders. Anxiety disorders co-occurring with medical illnesses have a number of clinical implications, including a greater severity and negative impact on treatment outcome of both medical illnesses and anxiety disorders. SUMMARY It is important for clinicians to look for possible anxiety disorders among patients with medical illnesses. Further studies need to ascertain how to best treat individuals suffering from both anxiety disorders and medical illnesses, and focus on the issue of causality when these conditions co-occur.
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World Arthritis Day 2018 and National Mental Illness Awareness Week. MMWR. MORBIDITY AND MORTALITY WEEKLY REPORT 2018. [PMCID: PMC6171897 DOI: 10.15585/mmwr.mm6739a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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