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Socioeconomic status and the risk for being diagnosed with spondyloarthritis and chronic pain: a nested case-control study.

Jöud, Anna LU ; Petersson, Ingemar LU ; Jordan, Kelvin P; Löfvendahl, Sofia LU ; Grahn, Birgitta LU and Englund, Martin LU (2014) In Rheumatology International 34(9). p.1291-1298
Abstract
Socioeconomic status could potentially impact on which type of rheumatic diagnosis a patient receives. We determined whether different socioeconomic status is a risk factor for being diagnosed with spondyloarthritis (SpA) or chronic pain. In a nested case-control study, we identified two sets of adult cases diagnosed with (i) SpA (n = 1,194) and (ii) chronic pain (n = 3,730) during 2010-2012 in Skåne region, Sweden. We randomly sampled controls matched for age and sex. Level of education, marital status, and income were identified in national registers 4 years before inclusion. We also studied health-care utilization, prescribed pharmaceuticals, and work status. We used conditional logistic regressions and included socioeconomic variables... (More)
Socioeconomic status could potentially impact on which type of rheumatic diagnosis a patient receives. We determined whether different socioeconomic status is a risk factor for being diagnosed with spondyloarthritis (SpA) or chronic pain. In a nested case-control study, we identified two sets of adult cases diagnosed with (i) SpA (n = 1,194) and (ii) chronic pain (n = 3,730) during 2010-2012 in Skåne region, Sweden. We randomly sampled controls matched for age and sex. Level of education, marital status, and income were identified in national registers 4 years before inclusion. We also studied health-care utilization, prescribed pharmaceuticals, and work status. We used conditional logistic regressions and included socioeconomic variables and geographic area in the models. Low (odds ratio [OR] 1.69 95 % CI 1.50-1.91) or moderate education (OR 1.43 95 % CI 1.30-1.57), and low (OR 1.40 95 % CI 1.25-1.57) or moderate income (OR 1.24 95 % CI 1.10-1.38) were associated with a chronic pain diagnosis. For a SpA diagnosis, moderate income (OR 1.25 95 % CI 1.04-1.50) was the only significant factor identified. Both case groups had a larger proportion that did not work (P < 0.001), used more health care (P < 0.001), and were more frequently prescribed NSAIDs (P < 0.001) 4 years before diagnosis than controls. We confirmed that lower levels of education and income are associated with a chronic pain diagnosis. This association may reflect a true higher incidence of chronic pain and/or increased consultation propensity for such pain in people with socioeconomic status. We found no such association for SpA. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Rheumatology International
volume
34
issue
9
pages
1291 - 1298
publisher
Springer
external identifiers
  • pmid:24825253
  • wos:000341371900017
  • scopus:84906939143
ISSN
1437-160X
DOI
10.1007/s00296-014-3039-6
language
English
LU publication?
yes
id
03281055-f869-4b74-9fc4-f31be93db484 (old id 4455287)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24825253?dopt=Abstract
date added to LUP
2014-06-03 23:57:56
date last changed
2017-08-13 03:05:45
@article{03281055-f869-4b74-9fc4-f31be93db484,
  abstract     = {Socioeconomic status could potentially impact on which type of rheumatic diagnosis a patient receives. We determined whether different socioeconomic status is a risk factor for being diagnosed with spondyloarthritis (SpA) or chronic pain. In a nested case-control study, we identified two sets of adult cases diagnosed with (i) SpA (n = 1,194) and (ii) chronic pain (n = 3,730) during 2010-2012 in Skåne region, Sweden. We randomly sampled controls matched for age and sex. Level of education, marital status, and income were identified in national registers 4 years before inclusion. We also studied health-care utilization, prescribed pharmaceuticals, and work status. We used conditional logistic regressions and included socioeconomic variables and geographic area in the models. Low (odds ratio [OR] 1.69 95 % CI 1.50-1.91) or moderate education (OR 1.43 95 % CI 1.30-1.57), and low (OR 1.40 95 % CI 1.25-1.57) or moderate income (OR 1.24 95 % CI 1.10-1.38) were associated with a chronic pain diagnosis. For a SpA diagnosis, moderate income (OR 1.25 95 % CI 1.04-1.50) was the only significant factor identified. Both case groups had a larger proportion that did not work (P &lt; 0.001), used more health care (P &lt; 0.001), and were more frequently prescribed NSAIDs (P &lt; 0.001) 4 years before diagnosis than controls. We confirmed that lower levels of education and income are associated with a chronic pain diagnosis. This association may reflect a true higher incidence of chronic pain and/or increased consultation propensity for such pain in people with socioeconomic status. We found no such association for SpA.},
  author       = {Jöud, Anna and Petersson, Ingemar and Jordan, Kelvin P and Löfvendahl, Sofia and Grahn, Birgitta and Englund, Martin},
  issn         = {1437-160X},
  language     = {eng},
  number       = {9},
  pages        = {1291--1298},
  publisher    = {Springer},
  series       = {Rheumatology International},
  title        = {Socioeconomic status and the risk for being diagnosed with spondyloarthritis and chronic pain: a nested case-control study.},
  url          = {http://dx.doi.org/10.1007/s00296-014-3039-6},
  volume       = {34},
  year         = {2014},
}