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Poole JL, Forno K, Prokopiak A, Skipper B. Importance and difficulty with valued life activities for people with systemic sclerosis. Disabil Rehabil 2023; 45:220-225. [PMID: 35104183 DOI: 10.1080/09638288.2022.2028910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
PURPOSE To identify the importance of and difficulty with valued activities in persons with systemic sclerosis (SSc) and to examine relationships between disease symptoms and difficulty with valued activities using the Valued Activities Scale (VLA). A secondary purpose was to examine the internal consistency of the Short-VLA Scale (S-VLA). METHODS A cross-sectional convenience sample of 99 people with SSc completed questionnaires regarding demographics, symptom severity, Health Assessment Questionnaire (HAQ), Center for Epidemiologic Studies Depression Scale (CES-D), and the VLA. RESULTS Obligatory activities were rated as most important; committed activities were significantly more difficult than obligatory and discretionary. Less fatigue (p < 0.01) and lower HAQ (p < 0.001) and CES-D (p < 0.01) scores were associated with higher total VLA scores. Internal consistency of the S-VLA was excellent (Cronbach's alpha = 0.92; p < 0.0001). The correlation between the S-VLA and the VLA was excellent (r = 0.96; p < 0.001). There were moderate correlations between the S-VLA and the HAQ (r = 0.73; p < 0.0001); the correlation with the CES-D was only fair (r = 0.35; p < 0.001). CONCLUSIONS Committed and discretionary activities were more difficult for people with SSc to perform. Results are similar to findings with people with rheumatoid arthritis and systemic lupus erythematosus.IMPLICATIONS FOR REHABILITATIONHome management/caregiving (committed) and leisure and social participation (discretionary) activities are more difficult to perform by people with SSc compared to self-care (obligatory) activities.Our findings that difficulty scores on the VLA were associated with more fatigue and depression suggest the need for rehabilitation to reduce disability in people with SSc.The S-VLA may be a useful screening and monitoring tool for SSc and other chronic conditions.
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Affiliation(s)
- Janet L Poole
- Occupational Therapy Graduate Program, School of Medicine, University of New Mexico, Albuquerque, NM, USA
| | | | | | - Betty Skipper
- Department of Family and Community Medicine, School of Medicine, University of New Mexico, Albuquerque, NM, USA
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Mattila K, Rankala R, Voutilainen M, Mustonen A. Inflammatory bowel disease: perceived impact on leisure-time activities. Scand J Gastroenterol 2022; 57:930-935. [PMID: 35196200 DOI: 10.1080/00365521.2022.2042593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Inflammatory bowel disease, consisting of Crohn's disease and ulcerative colitis, is known to negatively impact an individual's quality of life. Leisure-time activities are an important part of life by creating and strengthening social networks. The aim of this study was to thoroughly evaluate the perceived impact of inflammatory bowel disease on leisure-time activities by quantifying limitations in activities caused by the disease. METHODS A structured questionnaire, hospital records and national registers were combined to assess limitations caused by the disease in a patient's leisure-time activities. The final study sample was 561 patients. RESULTS More than half of the patients (52.8%) reported that IBD had caused limitations in their leisure-time activities. Women perceived that their limitations were greater when compared to the reports by men. One-third of the patients (33.3%) reported reducing and 17.6% abandoning at least one leisure-time activity due to their disease. Most often mentioned activities that were reduced and abandoned were physical activities. The IBDQ32 score had a significant correlation with all of the studied outcomes. Laboratory tests results and the patient's age or the level of income did not correlate with limitations in leisure-time activities. CONCLUSIONS In conclusion, this study showed that patients with inflammatory bowel disease perceived a marked limitation in their leisure-time activities due to their disease.
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Affiliation(s)
- Kalle Mattila
- Department of Emergency Medicine, Turku University Hospital, Turku, Finland.,Department of Public Health, University of Turku, Turku, Finland
| | - Rasmus Rankala
- Department of Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Markku Voutilainen
- Department of Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland.,Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Anssi Mustonen
- Department of Internal Medicine, Turku University Hospital, University of Turku, Turku, Finland
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Terpstra SE, van de Stadt L, Boonen A, Damman W, Rosendaal F, Kloppenburg M. Hand osteoarthritis is associated with limitations in paid and unpaid work participation and related societal costs: the HOSTAS cohort. RMD Open 2022; 8:rmdopen-2022-002367. [PMID: 35906024 PMCID: PMC9345053 DOI: 10.1136/rmdopen-2022-002367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/30/2022] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Data on work participation impairment and related societal costs for patients with hand osteoarthritis (OA) are scarce. Therefore, we aimed to investigate the association of hand OA with work limitations and costs of productivity loss in paid and unpaid work. METHODS We used data from the Hand Osteoarthritis in Secondary Care cohort, including patients with hand OA diagnosed by their treating rheumatologist. Using the validated Health and Labour Questionnaire, we assessed experienced unpaid and paid work restrictions, unpaid work replacement by others and inefficiency and absence during paid work related to hand OA over the last 2 weeks. Societal costs (€) per hour of paid and unpaid work were estimated using Dutch salary data in 2019. RESULTS 381 patients were included (mean age 61 years, 84% women, 26% high education level, 55% having any comorbidity). Replacement of unpaid work by others due to hand OA was necessary for 171 out of 381 patients (45%). Paid work was reported by 181/381 patients (47%), of whom 13/181 (7%) reported absenteeism, 28/181 (15%) unproductive hours at work and 120/181 (66%) paid work restrictions due to hand OA.Total estimated work-related societal costs per patient with hand OA (381 patients) were €94 (95% CI 59 to 130) per 2 weeks (€2452, 95% CI 1528 to 3377 per year). CONCLUSIONS Hand OA is associated with impairment in paid and unpaid work participation, which translates into substantial societal costs of lost productivity. These results highlight the importance of adequate hand OA treatment.
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Affiliation(s)
| | | | - Annelies Boonen
- Department of Internal Medicine, Division of Rheumatology, Maastricht University Medical Center and the Caphri Research Institute Maastricht University, Maastricht, The Netherlands
| | - Wendy Damman
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Frits Rosendaal
- Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Margreet Kloppenburg
- Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.,Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Byun HG, Jang M, Yoo HK, Potter J, Kwon TS. Budget Impact Analysis of the Introduction of Subcutaneous Infliximab (CT-P13 SC) for the Treatment of Rheumatoid Arthritis in the United Kingdom. Appl Health Econ Health Policy 2021; 19:735-745. [PMID: 34383287 DOI: 10.1007/s40258-021-00673-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND CT-P13 subcutaneous (SC)-the first and only SC version of infliximab-is approved by the European Medicines Agency for the treatment of rheumatoid arthritis (RA). This new mode of infliximab administration will allow patients to self-inject at home, significantly reducing the number of outpatient visits and costs of intravenous (IV) administration. This paper describes the economic impact of introducing CT-P13 SC to the market from the UK societal perspective. OBJECTIVE The budget impact analysis was conducted to assess the financial impact of the adoption of CT-P13 SC over a 5-year period. METHODS A prevalence-based budget impact model was developed incorporating epidemiological data, administration cost data, and market share data. The analysis compared a "world with" CT-P13 SC scenario to a "world without" CT-P13 SC. A sensitivity analysis included dose escalation up to 4.1 mg/kg to reflect the real-world care delivery setting. RESULTS Compared to the "world without" scenario, the introduction of CT-P13 SC resulted in cost savings of ₤69.3 million in the UK over a 5-year period. In the scenario analysis, the saving increased to ₤173.5 million over 5 years. CONCLUSION Use of CT-P13 SC may lead to substantial cost savings for the UK society.
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Affiliation(s)
- Han Geul Byun
- Celltrion Healthcare, 19, Academy-ro 51, Yeonsu-gu, Incheon, 22014, Republic of Korea
| | - Minyoung Jang
- Celltrion Healthcare, 19, Academy-ro 51, Yeonsu-gu, Incheon, 22014, Republic of Korea
| | - Hyun Kyeong Yoo
- Celltrion Healthcare, 19, Academy-ro 51, Yeonsu-gu, Incheon, 22014, Republic of Korea
| | - James Potter
- Celltrion Healthcare United Kingdom Limited, 1-7 The Switch, The Grove, Slough, UK
| | - Taek Sang Kwon
- Celltrion Healthcare, 19, Academy-ro 51, Yeonsu-gu, Incheon, 22014, Republic of Korea.
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von Granitz H, Sonnander K, Reine I, Winblad U. Do personal assistance activities promote participation in society for persons with disabilities in Sweden? A five-year longitudinal study. Disabil Rehabil 2021; 44:3973-3981. [PMID: 33721545 DOI: 10.1080/09638288.2021.1897691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To explore whether the personal assistance (PA) activities provided by the Swedish Act concerning Support and Service for Persons with Certain Functional Impairment in 2010 and 2015 promote participation in society according to Article 19 of the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD). METHODS Register data and data from two questionnaires were used (N = 2565). Descriptive statistics and chi-square (McNemar's test) were used to describe the basic features of the data. Mixed binominal logistic regression was used to examine correlation between gender and hours of PA between 2010 and 2015. RESULTS Despite an increase in the number of PA hours, more care activities and a reduction of most PA activities representing an active life were found. The result was especially evident for women, older people, and for a particular person category. CONCLUSIONS The results offer evidence of a shift to a medical model and indicate a risk of social exclusion due to fewer activities representing an active life. An increase on average of 16 h of PA over the period studied does not guarantee access to an active life and may indicate a marginal utility. The noted decline of PA for participation in society enhances the importance of monitoring content aspects to fulfil Article 19 of the UNCRPD.Implications for RehabilitationPersonal assistance (PA) in Sweden is a supportive measure for persons with disabilities; however, there are few studies to show whether PA activities are fulfilling disability rights of participation in society.The results show that PA activities are used more for medical care and home-based services over the five-year period.The study highlights the importance of monitoring aspects of content to ensure that the activities of PA comply with the policy objectives of the LSS legislation and Article 19 of the United Nations' Convention on the Rights of Persons with Disabilities (UNCRPD), i.e., full participation in society. Monitoring efforts should include individualised planning and follow-up, moreover, ensure compliance with social service capacity at PA providers.
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Affiliation(s)
- Heléne von Granitz
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Department of Public Health and Caring Sciences, Disability and Habilitation, Uppsala University, Uppsala, Sweden
| | - Ieva Reine
- Statistics Unit, Riga Stradins University, Riga, Latvia
| | - Ulrika Winblad
- Department of Public Health and Caring Sciences, Health Services Research, Uppsala University, Uppsala, Sweden
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Haider S, Sedlak M, Kapan A, Grabovac I, Lamprecht T, Erlacher L, Quittan M, Fenzl KH, Dorner TE. Factors Associated with Objectively Measured Physical Activity in Patients with Seropositive Rheumatoid Arthritis. Int J Environ Res Public Health 2020; 17:ijerph17239008. [PMID: 33287268 PMCID: PMC7730293 DOI: 10.3390/ijerph17239008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/26/2020] [Accepted: 11/28/2020] [Indexed: 12/13/2022]
Abstract
Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease, which is associated with low levels of physical activity (PA). However, the factors related to low physical activity levels have rarely been studied. Methods: In this cross-sectional study, 70 seropositive RA patients were included. Physical activity was objectively assessed with an ActiGraph GT3X+ accelerometer. In addition, body mass index, smoking status, work ability, and clinical parameters (functional disabilities, disease activity, disease duration, pain, and inflammation parameters) were measured. Results: RA patients performed a mean of 215.2 (SD: 136.6) min a week of moderate physical activity and 9.1 (SD: 26.3) min of vigorous physical activity. The total amount of moderate and vigorous physical activity (MVPA) was associated with BMI, and functional disabilities. In addition, non-smokers and patients with better work ability did more MVPA. No association could be seen with disease activity, disease duration, pain, and inflammatory markers. After mutual adjusting of all the variables, only BMI showed a significant relationship with MVPA. Conclusions: RA patients perform de facto no physical activity with vigorous intensity. Factors related to low physical activity are BMI, functional disabilities, workability and smoking status, whereas due to the study design no causal and temporal link could be made.
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Affiliation(s)
- Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (S.H.); (M.S.); (A.K.); (T.E.D.)
| | - Michael Sedlak
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (S.H.); (M.S.); (A.K.); (T.E.D.)
| | - Ali Kapan
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (S.H.); (M.S.); (A.K.); (T.E.D.)
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (S.H.); (M.S.); (A.K.); (T.E.D.)
- Correspondence: ; Tel.: +431-40160-34897
| | - Thomas Lamprecht
- Karl Landsteiner Institute for Autoimmune Disease and Rheumatology, 1100 Vienna, Austria; (T.L.); (L.E.); (K.H.F.)
| | - Ludwig Erlacher
- Karl Landsteiner Institute for Autoimmune Disease and Rheumatology, 1100 Vienna, Austria; (T.L.); (L.E.); (K.H.F.)
- 2nd Medical Division, Rheumatology, Klinik Favoriten, 1130 Vienna, Austria
| | - Michael Quittan
- Karl Landsteiner Institute for Remobilization and Functional Health, 1130 Vienna, Austria;
| | - Karl Heinrich Fenzl
- Karl Landsteiner Institute for Autoimmune Disease and Rheumatology, 1100 Vienna, Austria; (T.L.); (L.E.); (K.H.F.)
| | - Thomas Ernst Dorner
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (S.H.); (M.S.); (A.K.); (T.E.D.)
- Karl Landsteiner Institute for Health Promotion Research, 3454 Sitzenberg-Reidling, Austria
- Social Insurance Fund for Public Service, Railway and Mining Industries, Health Promotion Facility Sitzenberg-Reidling, 3454 Sitzenberg-Reidling, Austria
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Naqvi AA, Hassali MA, Naqvi SBS, Kachela B, Khan I. Estimation of direct cost of managing rheumatoid arthritis treatment to Pakistani patients using real-world follow-up data. Int J Rheum Dis 2019; 23:325-333. [PMID: 31880102 DOI: 10.1111/1756-185x.13776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 11/27/2019] [Accepted: 12/02/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aimed to estimate annual direct cost attributed to rheumatoid arthritis (RA) treatment from a patient's perspective using real-world patient follow-up data from hospitals' electronic database. METHODS A prospective 1-year study was conducted in rheumatology clinics of tertiary care hospitals of Karachi, Pakistan. Cost-of-illness methodology was used and all patient data related to costs of rheumatologist visits, physical therapy sessions, medications, assistive devices and laboratory investigations were obtained directly in printed hardcopies from patient electronic databases using their medical record numbers. Transportation cost was calculated from patient-reported log books. Data were analyzed through IBM SPSS version 23. Patients were asked to sign a written consent and the study was ethically approved. RESULTS The mean age of patients (N = 358) was 48 years. Most patients (73.7%) were female, married (86%) and had basic education (71.8%). Average cost of rheumatologist visits was PKR 11 510.61 (USD: 72.05) while it was PKR 66 947.37 (USD: 419.07) for physical therapy sessions. On average, medicines and medical devices costs were estimated at PKR 10 104.23 (USD: 63.25) and PKR 7848.48 (USD: 49.13) respectively. Cost attributed to diagnostic and laboratory charges was PKR 1962.12 (USD: 12.28) and travel expense was PKR 6541 (USD: 40.95). The direct expenditure associated with managing RA was PKR 37 558 (USD: 235.1). All costs were reported per annum. CONCLUSION Patient with RA in Pakistan pay a considerable amount of their income for managing their condition. Most patients have no provision for insurance which is a need considering the nature of the disease and associated productivity loss that would significantly lower income as the disease progresses.
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Affiliation(s)
- Atta Abbas Naqvi
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Mohamed Azmi Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | | | - Bharti Kachela
- Department of Medical Affairs and Pharmacovigilance, Searle Pakistan Ltd, Karachi, Pakistan
| | - Irfanullah Khan
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
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Proffitt R, Abraham M, Hughes C. Experiences of individuals with arthritis who participate in quilting-related leisure activities. International Journal of Therapy and Rehabilitation 2019. [DOI: 10.12968/ijtr.2018.0099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Individuals with arthritis experience physiological impacts from the condition that affect their participation in everyday activities. The latest literature suggests a need for more in-depth exploration of how hand impairments impact participation in leisure activities. This qualitative study explores the lived experience of individuals with arthritis who participate in quilting and sewing as a leisure activity. Methods The Person-Environment-Occupation model provided a framework for this study. Semi-structured interviews were conducted with four individuals with arthritis. Participants interviewed in person also gave feedback on quilting tools. Results Environmental supports (from tools or social circles) and physiological changes from the arthritis impacted performance of and participation in quilting. The participants were already independently making modifications to maximise participation in quilting and sewing, even though none had consulted with health care professionals. Conclusions Knowledge of task analysis and ergonomics allows occupational therapists to support performance through collaboration with clients on modifications to support participation.
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Affiliation(s)
- Rachel Proffitt
- Assistant Professor, Department of Occupational Therapy, University of Missouri, Columbia, Missouri, USA
| | - Meredith Abraham
- Graduate, Saint Louis University Hospital, St. Louis, Missouri, USA
| | - Christina Hughes
- Occupational Therapist, Saint Louis University Hospital, St. Louis, Missouri, USA
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Chancay MG, Guendsechadze SN, Blanco I. Types of pain and their psychosocial impact in women with rheumatoid arthritis. Womens Midlife Health 2019; 5:3. [PMID: 31417683 PMCID: PMC6688257 DOI: 10.1186/s40695-019-0047-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Accepted: 08/01/2019] [Indexed: 02/06/2023] Open
Abstract
Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease predominantly affecting middle-aged women. Very commonly, pain is a manifestation of active disease and because untreated RA can result in joint deformities, the current evaluation of pain has largely focused on inflammation. In addition, treatment has centered on the premise of reducing disease activity with the hopes of halting worsening damage, preventing future deformities, and ultimately providing pain relief for the patient. Yet research shows that all patients with RA, but women in particular, often suffer from increased mechanical pain and fibromyalgia, as well as anxiety, depression, sleep disturbances, sexual dysfunction, and disability, which add to the burden of the illness. Determining and addressing alternative pain triggers as well as understanding the psychosocial burden of RA is key in treating patients, especially in those who may not improve with traditional pharmacotherapy.
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Affiliation(s)
- Maria Gabriela Chancay
- 1Department of Rheumatology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Forchh 701N, Bronx, NY 10461 USA
| | | | - Irene Blanco
- 1Department of Rheumatology, Albert Einstein College of Medicine, 1300 Morris Park Ave, Forchh 701N, Bronx, NY 10461 USA
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