Evidence map›Paper›PMID 39365381›Full record

ArticleClinical rheumatology2024

Functional disability and disease activity are affected by social determinants of health in patients with rheumatoid arthritis.

Mohammad Movahedi, Kangping Cui, George Tomlinson, Angela Cesta, Xiuying Li, Claire Bombardier

Abstract read
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Article in Clinical rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

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4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mohammad MovahediToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada. Mohammad.movahedi@uhn.ca.ORCID http://orcid.org/0000-0001-6154-0121
Kangping CuiSunnybrook Health Sciences Centre, Toronto, ON, Canada.
George TomlinsonToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Angela CestaToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Xiuying LiToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.
Claire BombardierToronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe relationship between social determinants of health (SDH) and disease outcomes in rheumatoid arthritis (RA) is not well documented.

methodsData were extracted from the Ontario Best Practices Research Initiative (OBRI) registry for patients between January 2008 and April 2022. Adjusted mixed models analysis was used to investigate the effect of baseline SDH on disease activity (Clinical Disease Activity Index (CDAI)) and functional disability (Health Assessment Questionnaire-Disability Index (HAQ-DI)) 12 months after enrollment. The analyses were completed on multiple imputed data.

resultsThere were 2651 patients with a mean age of 58.1 years (SD 12.9). The majority (77.8%) were female. Greater improvements in physical function were seen in patients who were full-time employed (difference =  - 0.20; 95% CI - 0.28, - 0.11), part-time employed (difference =  - 0.10; 95% CI - 0.19, - 0.02), or retired (difference =  - 0.17; 95% CI - 0.25, - 0.08), compared to unemployed, those with highest income ($75,000 or more) (difference =  - 0.23; 95% CI - 0.37, - 0.09). Caucasian was also associated with a positive impact on functional ability (difference =  - 0.09; 95% CI - 0.17, - 0.02). In contrast, smokers had smaller improvements in physical function (difference = 0.07; 95% CI 0.002, 0.14). Interestingly, women had greater improvement in CDAI (difference =  - 2.40; 95% CI - 3.29, - 1.51), while they reported less improving in their physical function (difference = 0.33; 95% CI 0.27-0.39). Achieving CDAI low disease activity/remission state was also more common in females.

conclusionsOur findings suggest that disease activity and functional disability are affected by different SDH factors. The effects of SDH should be better understood and addressed by rheumatologists to provide equitable healthcare for all patients with RA. Key points • This study explored a comprehensive panel of social determinants of health and their relationship to clinical outcomes. • Previously unreported factors such as employment status and income were found to influence clinical outcomes. • Our findings can help physicians to identify high-risk patients who may benefit from additional attention to their social background.

Indexed as

Arthritis, RheumatoidDisability EvaluationSeverity of Illness IndexSocial Determinants of HealthAdultAgedEmploymentFemaleHumansMaleMiddle AgedOntarioPersons with DisabilitiesRegistriesClinical outcomesReal-world dataRheumatoid arthritisSocial determinant of health

Identifiers

PMID39365381

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.