Patient Empowerment and Associations with Disease Activity and Pain‐Related and Lifestyle Factors in Patients With Rheumatoid Arthritis

Abstract

Background. Empowerment is important to patients with rheumatoid arthritis (RA) because most care is in the form of self-management. The aim was to study levels of empowerment and associated variables in patients with RA and to investigate longitudinal clinical data in patients with low and high empowerment.Methods. A postal survey was sent in 2017 to patients with RA from the BARFOT (Better Anti-Rheumatic Pharmacotherapy) cohort that included questions about disease activity, pain-related factors, lifestyle habits, and contained the Swedish Rheumatic Disease Empowerment Scale (SWE-RES-23). The 844 patients who answered the SWE-RES-23 made up the cohort of the present study. Differences in level of empowerment between groups (low, moderate, and high empowerment) were analyzed with ANOVA. Logistic regression analysis was used to study variables associated with low empowerment. Thirdly, we performed comparisons in longitudinal data (15 years) of disease activity, pain, and physical function between the three empowerment groups (low, moderate, and high empowerment).Results. Patients with low empowerment (n = 282) were significantly older, more often women, and reported worse pain-related factors and physical function and lower moderate and vigorous physical activity compared with those with high empowerment (n = 270). An analysis of longitudinal data found that patients with low empowerment had worse pain and physical function at all time points. Conclusion.Patients with low empowerment have more pain-related symptoms, poorer physical function, and are less physically active. To promote patient empowerment in rehabilitation interventions it is important to identify and support self-management.Health Organization states that empowerment is a process to gain greater control over decisions and actions influencing health and to obtain the ability to control one's life. The empowerment process entails involving patients to understand their role, receive adequate individual patient education, and receive encouragement to become co-actors in shared decisionmaking and make informed decisions regarding their health and life (5). For patients with RA, being empowered means that patients have a belief in their own capacity to manage everyday life, which could cover managing fatigue, pain, and physical functioning. Managing a chronic disease, such as RA, entails patients being able to make informed decisions and change their priorities, with a view to optimizing their quality of life (6). Among patients with RA, it has been seen that the focus on No funding was received for this article.

Empoderamiento y calidad de vida en adultos con enfermedad celíaca en El Salvador. Estudio transversal

“…Existe una relación moderada positiva entre el empoderamiento y la CV de las personas adultas con EC en El Salvador (rho = 0,444; p = 0,007) (Figura 1). 17 [13,25] 19 [18][19][20] 0,394 17 [7, 19 [15][16][17][18][19]5] 17 [14][15][16][17][18] 0,624 15 [14][15][16][17][18] 19 [11][12][13][14][15][16][17][18][19][20] 17 [14-18, con artritis reumatoide es comparable con el de otras enfermedades crónicas y agregó que el nivel de empoderamiento está asociado a factores relacionados con la CV, la función física y los niveles de actividad física. Las personas con un nivel bajo de empoderamiento reportaron un nivel también bajo de CV.…”

“…Las personas con un nivel bajo de empoderamiento reportaron un nivel también bajo de CV. 13 La correlación entre empoderamiento y CV también se confirmó en un estudio transversal en Portugal en personas con enfermedad reumática. El estudio corroboró que el empoderamiento se relaciona positiva y significativamente con todas las dimensiones de la CV.…”

“…12 La información concerniente al nivel de empoderamiento de la persona y su impacto en la enfermedad que padece es escasa. 13 En las ciencias de la salud, no existe una definición unívoca de empoderamiento. No hay consenso sobre qué conceptos relacionados ayudan a establecer su significado.…”

The effect of a tight control regime with monthly follow‐up on remission rates and reported pain in early rheumatoid arthritis

“…Theoretically, a tight control regime could increase the patient's sense of security and confidence in the treatment, which could have a positive impact on their perception of pain (Edwards et al., 2016). A recent study has shown lower pain and better physical function in patients who report greater empowerment (Larsson et al., 2021). Great demands are made on the patient's ability to manage one's own symptoms in rheumatological care.…”

Approaches to optimising access to NICE-approved biologic anti-TNFs for patients with rheumatoid arthritis with moderately active disease

“…The work of patient organisations has sought to highlight that any individual with moderately active disease may now benefit from the newly available biologic therapies, and they have encouraged patients to contact their rheumatology department for a review. Patient empowerment and engagement to take an active role on a treatment plan is essential [ 40 ]. This is facilitated by the use of patient-reported outcome measures (PROMs) for assessment of the aspects of life most impacted by RA.…”