Exploring Factors Influencing Patient Activation in Saudi Rheumatoid Arthritis Patients: A Nationwide Cross-Sectional Survey- Results from the COPARA Study

Abstract

Objectives: To evaluate patient activation in Rheumatoid Arthritis (RA) patients using the patient activation measure 13 (PAM-13) on a national level in Saudi Arabia. Method: A national survey was administered across multiple centres in Saudi Arabia. The survey assessed patient activation using the PAM-13. The Compliance Questionnaire for Rheumatology (CQR) and the RA Impact of Disease (RAID) tool, were assessed. The data from the survey were analysed, and the results were stratified based on activation level. All factors affecting patient activation were explored and reported. Results: A total of 1241 participants were included. Most of the patients were females (85%), the mean age was 47 (±14), and most patients lived in the central region (47%). The mean (±SD) patient activation score was 578.7 (±13.0). Patient activation was affected by multiple factors: demographic characteristics, such as education, with a beta value of 1.11 (95% CI 0.64~̵̶ 1.58, p<0.001). Higher CQR scores were associated with higher activation level, with a beta value of 2.61 (95% CI 0.80~̵̶ 4.44, p=0.005); and higher RAID scores were associated with lower activation levels, with a beta value of 3.13 (95% CI 1.36~̵̶ 4.91, p=0.001). Conclusions: Patient activation was affected by several demographic characteristics and impact of RA. A higher activation may improve compliance. Future longitudinal studies are required to confirm these findings and should explore the underlying mechanism of these effects.