Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt– a national health survey

Abstract

ObjectivesTo estimate the national prevalence of rheumatic and musculoskeletal diseases (RMDs) in the adult Portuguese population and to determine their impact on health-related quality of life (HRQoL), physical function, anxiety and depression.MethodsEpiReumaPt is a national health survey with a three-stage approach. First, 10 661 adult participants were randomly selected. Trained interviewers undertook structured face-to-face questionnaires that included screening for RMDs and assessments of health-related quality of life, physical function, anxiety and depression. Second, positive screenings for ≥1 RMD plus 20% negative screenings were invited to be evaluated by a rheumatologist. Finally, three rheumatologists revised all the information and confirmed the diagnoses according to validated criteria. Estimates were computed as weighted proportions, taking the sampling design into account.ResultsThe disease-specific prevalence rates (and 95% CIs) of RMDs in the adult Portuguese population were: low back pain, 26.4% (23.3% to 29.5%); periarticular disease, 15.8% (13.5% to 18.0%); knee osteoarthritis (OA), 12.4% (11.0% to 13.8%); osteoporosis, 10.2% (9.0% to 11.3%); hand OA, 8.7% (7.5% to 9.9%); hip OA, 2.9% (2.3% to 3.6%); fibromyalgia, 1.7% (1.1% to 2.1%); spondyloarthritis, 1.6% (1.2% to 2.1%); gout, 1.3% (1.0% to 1.6%); rheumatoid arthritis, 0.7% (0.5% to 0.9%); systemic lupus erythaematosus, 0.1% (0.1% to 0.2%) and polymyalgia rheumatica, 0.1% (0.0% to 0.2%). After multivariable adjustment, participants with RMDs had significantly lower EQ5D scores (β=−0.09; p<0.001) and higher HAQ scores (β=0.13; p<0.001) than participants without RMDs. RMDs were also significantly associated with the presence of anxiety symptoms (OR=3.5; p=0.006).ConclusionsRMDs are highly prevalent in Portugal and are associated not only with significant physical function and mental health impairment but also with poor HRQoL, leading to more health resource consumption. The EpiReumaPt study emphasises the burden of RMDs in Portugal and the need to increase RMD awareness, being a strong argument to encourage policymakers to increase the amount of resources allocated to the treatment of rheumatic patients.

Challenges of Ageing in Portugal: Data from the EpiDoC Cohort

“…Ethical issues and personal protection: Details of ethical issues of the EpiDoC 1 (EpiReumaPt) study were described elsewhere. 14,15,23 EpiDoC 1 was performed according to the principles established by the Declaration of Helsinki and revised in 2013 in Fortaleza. 24 The study was reviewed and approved by the National Committee for Data Protection (Comissão Nacional de Proteção de Dados) and by the NOVA Medical School Ethics Committee.…”

“…14, 15 The study included non-institutionalized adults (≥ 18 years old) living in private residences in the Portuguese Mainland and Islands (Madeira and Azores). The study sample was stratified by administrative territorial units [(NUTS II) (Norte, Centro, Lisboa & Vale do Tejo, Alentejo, Algarve, Azores Islands (Azores) and Madeira Islands (Madeira)], and the size of the population within each locality (< 2000; 2000 -9999; 10 000 -19 999; 20 000 -99 999; and ≥ 100 000 inhabitants, respectively).…”

“…This study primarily assessed the prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function, and mental health in Portugal. 14,15 In EpiDoC 1, face-to-face interviews were conducted at the residences of the 10 661 participants across the country, followed by a medical appointment one or two weeks later at the nearest primary health care centre. Detailed methodology was published elsewhere.…”

Calidad de vida, nivel de salud percibido y factores sociodemográficos en personas con artritis reumatoide

“…Asimismo, se encontró que la frecuencia de la enfermedad aumenta con la edad, ya que el 40 % de las personas afectadas fueron mayores de 60 años, lo cual concuerda con los datos del estudio de FrancoAguirre et al, donde los pacientes tenían una edad promedio de 53 ± 12 años (26). Los datos coinciden con lo reportado por Branco et al (27), donde se evidenció que el inicio más frecuente de la enfermedad está durante el cuarto y quinto decenios de la vida, de forma que el 80 % de todos los pacientes presenta la enfermedad entre los 35 y los 50 años de edad. Asimismo, el tiempo de la enfermedad mayor a 36 reafirma la consideración de la misma como una enfermedad crónica de alto costo.…”

Effectiveness of nursing consultations in people with rheumatoid arthritis: systematic review

“…Em Portugal estima-se que afete 0,7% da população adulta (Branco et al, 2016). A sua apresentação clínica é muito heterogénea e sistémica, não se circunscrevendo apenas à inflamação articular (Gabay et al, 2015).…”