Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes

Objective Electronic health applications (apps) allow patients with rheumatoid arthritis (RA) to report patient‐reported outcomes (PROs) between visits. However, almost no data exist on patients’ report of pain between visits and how that correlates with change in function and/or modifications to me...

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Main Authors: Hallie M. Altwies, Leah M. Santacroce, Javier Marrugo, Jacklyn Stratton, Jack Ellrodt, Robert S. Rudin, Daniel H. Solomon
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11768
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author Hallie M. Altwies
Leah M. Santacroce
Javier Marrugo
Jacklyn Stratton
Jack Ellrodt
Robert S. Rudin
Daniel H. Solomon
author_facet Hallie M. Altwies
Leah M. Santacroce
Javier Marrugo
Jacklyn Stratton
Jack Ellrodt
Robert S. Rudin
Daniel H. Solomon
author_sort Hallie M. Altwies
collection DOAJ
description Objective Electronic health applications (apps) allow patients with rheumatoid arthritis (RA) to report patient‐reported outcomes (PROs) between visits. However, almost no data exist on patients’ report of pain between visits and how that correlates with change in function and/or modifications to medication. Methods Patients with RA from one rheumatology practice provided data as part of a study of an app. Patients answered PRO short forms using the app, including the Patient‐Reported Outcomes Measurement Information System pain interference and physical function questionnaires. Each PRO was answered every eight days. We assessed the frequency of significant worsening in pain using the minimally clinically important difference (MCID) of ≥5 points. Logistic regression assessed whether worsening in pain was associated with functional declines and/or RA medication changes. Results Among 150 patients with RA using the app, 83 patients qualified for analysis; the mean age was 62 years, and 82% were female. The median number of pain interference PROs answered per patient was 37 over 52 weeks. Using the first five pain interference PRO responses as the baseline, 60 (72%) patients experienced worsening of at least the MCID, with a median duration of 16 days. The odds ratio (OR) relating significantly worsening pain to declines in function over the next 42 days was 2.71 (95% confidence interval [CI] 1.12–6.89). Worsening pain was not significantly associated with changes to RA medication (OR 1.59, 95% CI 0.62–4.17). Conclusion Clinically significant increases in pain among patients with RA are commonly associated with reductions in function but not with RA medication changes.
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spelling doaj-art-2b2f037cfa794ae3b395d031450839fa2025-02-04T06:21:23ZengWileyACR Open Rheumatology2578-57452025-01-0171n/an/a10.1002/acr2.11768Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication ChangesHallie M. Altwies0Leah M. Santacroce1Javier Marrugo2Jacklyn Stratton3Jack Ellrodt4Robert S. Rudin5Daniel H. Solomon6Brigham and Women's Hospital Boston MassachusettsBrigham and Women's Hospital Boston MassachusettsHarvard Medical School Boston MassachusettsBrigham and Women's Hospital Boston MassachusettsBrigham and Women's Hospital Boston MassachusettsRAND Corporation Boston MassachusettsBrigham and Women's Hospital and Harvard Medical School Boston MassachusettsObjective Electronic health applications (apps) allow patients with rheumatoid arthritis (RA) to report patient‐reported outcomes (PROs) between visits. However, almost no data exist on patients’ report of pain between visits and how that correlates with change in function and/or modifications to medication. Methods Patients with RA from one rheumatology practice provided data as part of a study of an app. Patients answered PRO short forms using the app, including the Patient‐Reported Outcomes Measurement Information System pain interference and physical function questionnaires. Each PRO was answered every eight days. We assessed the frequency of significant worsening in pain using the minimally clinically important difference (MCID) of ≥5 points. Logistic regression assessed whether worsening in pain was associated with functional declines and/or RA medication changes. Results Among 150 patients with RA using the app, 83 patients qualified for analysis; the mean age was 62 years, and 82% were female. The median number of pain interference PROs answered per patient was 37 over 52 weeks. Using the first five pain interference PRO responses as the baseline, 60 (72%) patients experienced worsening of at least the MCID, with a median duration of 16 days. The odds ratio (OR) relating significantly worsening pain to declines in function over the next 42 days was 2.71 (95% confidence interval [CI] 1.12–6.89). Worsening pain was not significantly associated with changes to RA medication (OR 1.59, 95% CI 0.62–4.17). Conclusion Clinically significant increases in pain among patients with RA are commonly associated with reductions in function but not with RA medication changes.https://doi.org/10.1002/acr2.11768
spellingShingle Hallie M. Altwies
Leah M. Santacroce
Javier Marrugo
Jacklyn Stratton
Jack Ellrodt
Robert S. Rudin
Daniel H. Solomon
Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
ACR Open Rheumatology
title Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
title_full Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
title_fullStr Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
title_full_unstemmed Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
title_short Longitudinal Assessment of Pain in Rheumatoid Arthritis: Increases in Pain and Their Relationship to Functional Declines and Medication Changes
title_sort longitudinal assessment of pain in rheumatoid arthritis increases in pain and their relationship to functional declines and medication changes
url https://doi.org/10.1002/acr2.11768
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