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Clinically suspect arthralgia and rheumatoid arthritis: patients' perceptions of illness.
Joint, Bone, Spine : Revue du Rhumatisme 2024 June 8
OBJECTIVES: Clinically suspect arthralgia (CSA) is an at-risk stage of rheumatoid arthritis (RA), in which patients experience symptoms and physical limitations. Perceptions of CSA-patients have remained largely unknown. Therefore, we aimed to map perceptions of CSA-patients and compare them to RA-patients. Additionally, we studied changes in perceptions in CSA over time.
METHODS: 399 consecutively included CSA-patients from the Leiden and Rotterdam CSA-cohorts and 100 recently diagnosed RA-patients from the Leiden Early Arthritis Clinic were included. Patients' illness perceptions (IP) were assessed using the Brief Illness Perception Questionnaire (BIPQ), consisting of 8 questions (scale 0-10; higher score indicating more negative IP) covering cognitive, emotional and comprehensibility domains, and one open question on causes of disease. IP were measured at baseline in both populations and during 2 years follow-up in the CSA-cohorts.
RESULTS: Total BIPQ-scores were comparable at CSA-presentation and RA-diagnosis (40±11 and 40±10; range 0-80). Comparing dimensions separately revealed that CSA-patients were less worried on physical complaints compared to RA-patients. However, CSA-patients were more negative about expected treatment-effect on symptoms. IP over time in CSA improved in patients without development of clinical arthritis (38±11 to 34±14; p=0.005) but remained similar in CSA-patients who progressed to arthritis/RA (mean 40 at both timepoints). CSA-patients mainly reported physical strain and heredity as perceived causes of their complaints.
CONCLUSIONS: Although CSA-patients have not developed clinical arthritis, illness perceptions at CSA-presentation and RA-diagnosis are equally severe. Knowledge on worries and expectations may contribute to improving patient-contact and care in patients at risk of RA.
METHODS: 399 consecutively included CSA-patients from the Leiden and Rotterdam CSA-cohorts and 100 recently diagnosed RA-patients from the Leiden Early Arthritis Clinic were included. Patients' illness perceptions (IP) were assessed using the Brief Illness Perception Questionnaire (BIPQ), consisting of 8 questions (scale 0-10; higher score indicating more negative IP) covering cognitive, emotional and comprehensibility domains, and one open question on causes of disease. IP were measured at baseline in both populations and during 2 years follow-up in the CSA-cohorts.
RESULTS: Total BIPQ-scores were comparable at CSA-presentation and RA-diagnosis (40±11 and 40±10; range 0-80). Comparing dimensions separately revealed that CSA-patients were less worried on physical complaints compared to RA-patients. However, CSA-patients were more negative about expected treatment-effect on symptoms. IP over time in CSA improved in patients without development of clinical arthritis (38±11 to 34±14; p=0.005) but remained similar in CSA-patients who progressed to arthritis/RA (mean 40 at both timepoints). CSA-patients mainly reported physical strain and heredity as perceived causes of their complaints.
CONCLUSIONS: Although CSA-patients have not developed clinical arthritis, illness perceptions at CSA-presentation and RA-diagnosis are equally severe. Knowledge on worries and expectations may contribute to improving patient-contact and care in patients at risk of RA.
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