Fatigue is a common problem for patients with inflammatory arthritis, such as rheumatoid arthritis (RA), and a new study in PLOS One has highlighted that the broad impact may have fatigue on patients with RA, psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA).
Danish researchers used a questionnaire-based cross-sectional questionnaire to collect patient characteristics from patients in Denmark with RA, PsA, and axSpA.
“Fatigue is considered a multidimensional and complex phenomenon and is found to be associated with pain, sleep problems and low physical activity,” the authors explained. ‘It has also been found that severe fatigue predicts depression, low physical activity and liveability, and more use of health care. On the other hand, depression, decreased beliefs of illness, psychological distress and low self-efficacy have been found to contribute to fatigue. ”
Data were collected on 487 patients over a 6-month period from January 2017 to June 2017. The majority (60%) of patients had RA (n = 292), 23% had axSpA (n = 110), and 17% had PsA (n = 85).
Patients completed a questionnaire that asked about their disease status, type of household, education, employment, and household income. The researchers also used respondents’ medical journals to gather information on type of diagnosis, age, gender, treatment, changes in treatment, and score of disease activity. For the disease activity score, Disease Activity Score 28 (DAS28) was used for RA and PsA, Bath Ankylosing Spondylitis Disease Activity Index for axSpA, and Bath Ankylosing Spondylitis Functional Index for PsA and axSpA.
Fatigue did not differ significantly between the disease groups. The functional assessment of chronic disease therapy (FACIT) fatigue scale ranges from 0 to 52, with higher scores indicating lower levels of fatigue. The FACIT Fatigue score was 34.9 for RA, 31.8 for PsA, and 34.8 for axSpA. In comparison, the general population has an average fatigue score of 44.0. While levels of fatigue were similar across the diseases, women, experienced patients, and patients who changed medication in the past 12 months all reported a higher average fatigue rate.
The socioeconomic characteristics that were significantly correlated with fatigue were education, employment, and income, with patients having less education, being unemployed / retired, and having a lower income with a higher average fatigue rate.
There was also a correlation between fatigue and limitation of work, liveability, pain, sleep problems, depression, and physical functioning.
The authors found that the limitations of their study included the fact that the cohort was slightly older and consisted of more women and the geographical scope was limited because the cohort was obtained from 2 clinics in the Capital Region of Denmark. She added that she could not draw any conclusions about causality because she was using a research paper.
“Fatigue can not be seen as a single problem, but as a symptom that life affects people with [inflammatory arthritis], ”Concluded the authors.
Reference
Appel Esbensen B, Elkjær Stallknecht S, Elmegaard Madsen M, Hagelund L, Pilgaard T. Correlations of fatigue in Danish patients with rheumatoid arthritis, psoriatic arthritis and spondyloarthritis. PLOS ONE. Online published August 3, 2020. doi: 10.1371 / journal.pone.0237117
