Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Comparison of chronic widespread pain prevalence with different criteria in two cohorts of rheumatoid arthritis

Aronsson, M. LU orcid ; Bergman, S. LU ; Lindqvist, E. LU orcid and Andersson, M. L.E. LU (2022) In Clinical Rheumatology 41(4). p.1023-1032
Abstract

Objective: This study aims to investigate chronic widespread pain with the 1990 (CWP1990) and 2019 (CWP2019) definitions 6 years after the onset of rheumatoid arthritis (RA), in one patient cohort with tight controls and one conventional cohort, and factors associated with reporting CWP1990 and CWP2019, respectively. Methods: A cohort of 80 RA patients with monthly visits to the physician the first 6 months was compared to a cohort of 101 patients from the same clinic with conventional follow-up. Both cohorts had early RA (< 13 months). The prevalence of CWP1990 and the more stringent CWP2019 were in a 6-year follow-up investigated with a questionnaire, including a pain mannequin and a fear-avoidance beliefs questionnaire. Results:... (More)

Objective: This study aims to investigate chronic widespread pain with the 1990 (CWP1990) and 2019 (CWP2019) definitions 6 years after the onset of rheumatoid arthritis (RA), in one patient cohort with tight controls and one conventional cohort, and factors associated with reporting CWP1990 and CWP2019, respectively. Methods: A cohort of 80 RA patients with monthly visits to the physician the first 6 months was compared to a cohort of 101 patients from the same clinic with conventional follow-up. Both cohorts had early RA (< 13 months). The prevalence of CWP1990 and the more stringent CWP2019 were in a 6-year follow-up investigated with a questionnaire, including a pain mannequin and a fear-avoidance beliefs questionnaire. Results: In the tight control cohort, 10% reported CWP2019 after 6 years compared to 23% in the conventional cohort (p = 0.026). There was no difference when using the CWP1990 definition (27% vs 31%, p = 0.546). When adjusted for important baseline data, the odds ratio for having CWP2019 was 2.57 (95% CI 1.02–6.50), in the conventional group compared to the tight control group (p = 0.046). A high level of fear-avoidance behaviour towards physical activity was associated with CWP2019, OR 10.66 (95% CI 1.01–112.14), but not with CWP1990 in the tight control cohort. Conclusion: A more stringent definition of CWP identifies patients with a more serious pain condition, which potentially could be prevented by an initial tight control management. Besides tight control, caregivers should pay attention to fear-avoidance behaviour and tailor treatment. Key Points: • CWP2019 is a more stringent definition of chronic widespread pain and identifies patients with a more serious pain condition. • Patients with a serious pain condition could be helped by frequent follow-ups. • This study suggests that a special attention of fear-avoidance behaviour towards physical activity in patients with RA is needed.

(Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Arthritis, Chronic pain, Lifestyle, Pain, Physical activity, Rheumatoid
in
Clinical Rheumatology
volume
41
issue
4
pages
1023 - 1032
publisher
Springer
external identifiers
  • scopus:85119843311
  • pmid:34812975
ISSN
0770-3198
DOI
10.1007/s10067-021-05999-8
language
English
LU publication?
yes
id
0b14a3a3-a4a7-4f83-b366-4ed48653166c
date added to LUP
2021-12-15 08:38:09
date last changed
2024-04-06 15:17:25
@article{0b14a3a3-a4a7-4f83-b366-4ed48653166c,
  abstract     = {{<p>Objective: This study aims to investigate chronic widespread pain with the 1990 (CWP1990) and 2019 (CWP2019) definitions 6 years after the onset of rheumatoid arthritis (RA), in one patient cohort with tight controls and one conventional cohort, and factors associated with reporting CWP1990 and CWP2019, respectively. Methods: A cohort of 80 RA patients with monthly visits to the physician the first 6 months was compared to a cohort of 101 patients from the same clinic with conventional follow-up. Both cohorts had early RA (&lt; 13 months). The prevalence of CWP1990 and the more stringent CWP2019 were in a 6-year follow-up investigated with a questionnaire, including a pain mannequin and a fear-avoidance beliefs questionnaire. Results: In the tight control cohort, 10% reported CWP2019 after 6 years compared to 23% in the conventional cohort (p = 0.026). There was no difference when using the CWP1990 definition (27% vs 31%, p = 0.546). When adjusted for important baseline data, the odds ratio for having CWP2019 was 2.57 (95% CI 1.02–6.50), in the conventional group compared to the tight control group (p = 0.046). A high level of fear-avoidance behaviour towards physical activity was associated with CWP2019, OR 10.66 (95% CI 1.01–112.14), but not with CWP1990 in the tight control cohort. Conclusion: A more stringent definition of CWP identifies patients with a more serious pain condition, which potentially could be prevented by an initial tight control management. Besides tight control, caregivers should pay attention to fear-avoidance behaviour and tailor treatment. Key Points: • CWP2019 is a more stringent definition of chronic widespread pain and identifies patients with a more serious pain condition. • Patients with a serious pain condition could be helped by frequent follow-ups. • This study suggests that a special attention of fear-avoidance behaviour towards physical activity in patients with RA is needed.</p>}},
  author       = {{Aronsson, M. and Bergman, S. and Lindqvist, E. and Andersson, M. L.E.}},
  issn         = {{0770-3198}},
  keywords     = {{Arthritis; Chronic pain; Lifestyle; Pain; Physical activity; Rheumatoid}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{1023--1032}},
  publisher    = {{Springer}},
  series       = {{Clinical Rheumatology}},
  title        = {{Comparison of chronic widespread pain prevalence with different criteria in two cohorts of rheumatoid arthritis}},
  url          = {{http://dx.doi.org/10.1007/s10067-021-05999-8}},
  doi          = {{10.1007/s10067-021-05999-8}},
  volume       = {{41}},
  year         = {{2022}},
}