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Low socio-economic status is associated with high physical limitations and low illness self-perception in patients with juvenile idiopathic arthritis: Results from the Childhood Arthritis Prospective Study (CAPS)
Suzanne M M Verstappen, Joanna Cobb, Helen E Foster, Bo Fu, Eileen Baildam, Lucy R Wedderburn, Joyce E Davidson, John Ioannou, Alice Chieng, Kimme L Hyrich, Wendy Thomson
Arthritis Care & Research. 2014;.
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Abstract
Objective. The objectives of this study were to examine the association between socio-economic status (SES) and delay to paediatric rheumatology clinic, disease severity and illness perception in patients with juvenile idiopathic arthritis (JIA) in England. Methods. Using the Index of Multiple Deprivation, 923 consecutive children from the Childhood Arthritis Prospective Study (CAPS) were assigned to the least deprived SES group (high-SES, 19.1%), middle-SES (44.5%) or low-SES group (36.4%). At baseline, disease activity was assessed and the health assessment questionnaire (CHAQ), the illness perception questionnaire (IPQ-R) and the Child Health Questionnaire (CHQ-PF50) completed. Linear, median regression analyses or zero-inflated negative binominal (ZINB) regression analyses were used. Results. Delay to first paediatric rheumatology consultation was not different between the three SES groups. Although disease activity scores assessed by the paediatric rheumatologist did not differ between the three SES groups, persons in the low SES-group recorded higher CHAQ-scores compared to the high SES-group (OR (95%CI) zero-inflated part ZINB 0.28 (0.14 to 0.55), β (95%CI) count part ZINB 0.26 (0.05 to 0.48)) and they reported more often that their children's school work or activities with friends had been limited. Furthermore, the low SES-group had a worse perception about the consequences of the disease and the effect of treatment than those in the high SES-group. Conclusion. Patients from lower SES background report more problems with daily activities and have a lower perception of the consequences of the disease than patients from higher SES background, warranting special attention from a multi disciplinary team.
Keyword(s)
disease activity; illness perception; juvenile idiopathic arthritis; patient reported outcome; socio-economic status