The effect of COVID-19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study

Abstract

Objective To quantify the change in quality of life, disease-specific indicators, health, and lifestyle before and during the COVID19 pandemic amongst people with musculoskeletal diagnoses and symptoms. Methods We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place. Results 1054 people took part in the study (596 axSpA, 162 PsA, 296 regional pain). In comparison to their previous (pre-pandemic) assessment, there was an age-adjusted significant, small, decrease in quality of life measured by EQ-5D (-0.020 95% CI (-0.030, -0.009)) overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender, and deprivation. Conclusion Important lessons include focussing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.

Worsening pain and quality of life for spine surgery patients during the COVID-19 pandemic: Roles of psychological distress and patient activation

“…Prior studies have documented increased psychological distress during previous epidemics or pandemics, including Ebola virus disease in 2014 [ 35 , 36 ] and severe acute respiratory syndrome (SARS) in 2003 [37] . Psychological distress during the COVID-19 pandemic has been shown to negatively affect health, leading to greater pain severity in patients with chronic pain [ 38 , 39 ] and reduction in patients with musculoskeletal conditions [40] . Our study suggests that individuals with psychological distress, especially depression, experience more detrimental impact on their pain and their satisfaction with participation in social roles compared with those without psychological distress as a response to the external stress of COVID-19.…”

Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study

“…The methods of data collection for this study are published. 8 Briefly, the cohorts comprising the CONTAIN Study included individuals meeting ASAS criteria for axial spondyloarthritis (Assessment of Spondyloarthritis International Society; axSpA 9 ;) who were originally recruited from 83 clinical rheumatology services (sites) across the UK during 2012–2017 (BSRBR-AS register); patients meeting classification criteria for psoriatic arthritis currently being recruited from sites across the UK (CASPAR 10 - Classification of Psoriatic Arthritis; BSR-PsA register); and people recruited from general practices in three Scottish health boards who had consulted with regional pain in primary care and other symptoms (sleep problems and somatic symptoms) 2016–2017 (MAmMOTH Study 11 - Maintaining Musculoskletal Health Study).…”

“…The questionnaire comprised existing validated instruments and questions specific to individuals’ experiences during the COVID-19 pandemic. 8 Relevant aspects for the current analysis included sociodemographic characteristics including gender, age and current (main) job and industry. Deprivation status was determined using postcodes with reference to either the population of Scotland, 12 England 13 or Wales.…”

Lessons from experiences of accessing healthcare during the pandemic for remobilizing rheumatology services: a national mixed methods study

“…Participants from three established cohorts took part in the CONTAIN Study and the methods of data collection for this study have been published [ 23 ]. The CONTAIN Study included individuals with axial SpA who were recruited from 83 clinical sites across the UK [British Society for Rheumatology Biologics Register Ankylosing Spondylitis (BSRBR-AS) Register] [ 24 ], people with PsA who are currently being recruited from sites across the UK [British Society for Rheumatology Psoriatic Arthritis (BSR-PsA) Register] [ 25 ] and people recruited from three Scottish health boards who had consulted with regional musculoskeletal pain and other symptoms [Maintaining Musculoskeletal Health (MAmMOTH) Study] [ 26 ].…”