Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study

Louise Hedenstierna; Anna Karin Hedström; Lars Klareskog; Daniela Di Giuseppe; Lars Alfredsson; Johan Askling; Sofia Ernestam; Saedis Saevarsdottir; Lotta Ljung

doi:10.1186/s13075-022-02892-w

Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study

Louise Hedenstierna^*, Anna Karin Hedström, Lars Klareskog, Daniela Di Giuseppe, Lars Alfredsson, Johan Askling, Sofia Ernestam, Saedis Saevarsdottir, Lotta Ljung

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

Abstract

Objectives: To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). Methods: This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Results: Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. Conclusion: In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.

Original language	English
Article number	203
Pages (from-to)	203
Journal	Arthritis Research and Therapy
Volume	24
Issue number	1
DOIs	https://doi.org/10.1186/s13075-022-02892-w
Publication status	Published - 23 Aug 2022

Bibliographical note

Funding Information:
Open access funding provided by Karolinska Institute. The EIRA study and the authors have been supported by grants from the Swedish Research Council, the Region Stockholm (ALF), the Swedish Heart Lung Foundation, the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s 80-Year Foundation, and the Swedish Rheumatism Foundation. LH was supported by research funding from Börje Dahlin’s research fund.

Publisher Copyright:
© 2022, The Author(s).

Other keywords

Antirheumatic Agents/therapeutic use
Arthritis, Rheumatoid/drug therapy
C-Reactive Protein
Cohort Studies
Humans
Remission Induction
Severity of Illness Index
Social Support
Sweden/epidemiology

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10.1186/s13075-022-02892-w

s13075-022-02892-wFinal published version, 749 KBLicence: CC BY

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Hedenstierna, L., Hedström, A. K., Klareskog, L., Di Giuseppe, D., Alfredsson, L., Askling, J., Ernestam, S., Saevarsdottir, S., & Ljung, L. (2022). Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study. Arthritis Research and Therapy, 24(1), 203. [203]. https://doi.org/10.1186/s13075-022-02892-w

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title = "Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study",

abstract = "Objectives: To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). Methods: This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Results: Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. Conclusion: In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.",

keywords = "Antirheumatic Agents/therapeutic use, Arthritis, Rheumatoid/drug therapy, C-Reactive Protein, Cohort Studies, Humans, Remission Induction, Severity of Illness Index, Social Support, Sweden/epidemiology",

author = "Louise Hedenstierna and Hedstr{\"o}m, {Anna Karin} and Lars Klareskog and {Di Giuseppe}, Daniela and Lars Alfredsson and Johan Askling and Sofia Ernestam and Saedis Saevarsdottir and Lotta Ljung",

note = "Funding Information: Open access funding provided by Karolinska Institute. The EIRA study and the authors have been supported by grants from the Swedish Research Council, the Region Stockholm (ALF), the Swedish Heart Lung Foundation, the Swedish Council for Health, Working Life and Welfare, King Gustaf V{\textquoteright}s 80-Year Foundation, and the Swedish Rheumatism Foundation. LH was supported by research funding from B{\"o}rje Dahlin{\textquoteright}s research fund. Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = aug,

day = "23",

doi = "10.1186/s13075-022-02892-w",

language = "English",

volume = "24",

pages = "203",

journal = "Arthritis Research and Therapy",

issn = "1478-6354",

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Hedenstierna, L, Hedström, AK, Klareskog, L, Di Giuseppe, D, Alfredsson, L, Askling, J, Ernestam, S, Saevarsdottir, S & Ljung, L 2022, 'Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study', Arthritis Research and Therapy, vol. 24, no. 1, 203, pp. 203. https://doi.org/10.1186/s13075-022-02892-w

Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis : results from the Swedish EIRA study. / Hedenstierna, Louise; Hedström, Anna Karin; Klareskog, Lars et al.

In: Arthritis Research and Therapy, Vol. 24, No. 1, 203, 23.08.2022, p. 203.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis

T2 - results from the Swedish EIRA study

AU - Hedenstierna, Louise

AU - Hedström, Anna Karin

AU - Klareskog, Lars

AU - Di Giuseppe, Daniela

AU - Alfredsson, Lars

AU - Askling, Johan

AU - Ernestam, Sofia

AU - Saevarsdottir, Saedis

AU - Ljung, Lotta

N1 - Funding Information: Open access funding provided by Karolinska Institute. The EIRA study and the authors have been supported by grants from the Swedish Research Council, the Region Stockholm (ALF), the Swedish Heart Lung Foundation, the Swedish Council for Health, Working Life and Welfare, King Gustaf V’s 80-Year Foundation, and the Swedish Rheumatism Foundation. LH was supported by research funding from Börje Dahlin’s research fund. Publisher Copyright: © 2022, The Author(s).

PY - 2022/8/23

Y1 - 2022/8/23

N2 - Objectives: To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). Methods: This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Results: Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. Conclusion: In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.

AB - Objectives: To investigate the association between psychosocial vulnerability, defined as either low social support or low decision latitude at work, and disease remission at 3, 12, and 60 months in patients with rheumatoid arthritis (RA). Methods: This cohort study included all patients enrolled in both the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) 1996–2015 and the Swedish Rheumatology Quality Register (SRQ, n = 2820). Information on social support and decision latitude at work at RA diagnosis were identified from the EIRA questionnaire. Indexes for levels of social support and decision latitude at work, respectively, were calculated based on the questionnaire. Low social support and low decision latitude at work, respectively, were identified by a score in the lowest quartile and compared with the three other quartiles (not low). Disease-activity parameters were retrieved from SRQ at 3, 12, and 60 months. The associations between social support or decision latitude at work, respectively, and Disease Activity Score 28 joint count with C-reactive protein (DAS28-CRP) remission were analysed using logistic regression models adjusted for age, sex, smoking habits, alcohol habits, symptom duration, and educational level. Results: Having low social support (n = 591) was not associated with DAS28-CRP remission at 3 (OR 0.93, 95% CI 0.74–1.16), 12 (OR 0.96, 95%CI 0.75–1.23), or 60 (OR 0.89, 95%CI 0.72–1.10) months compared to not low social support (n = 2209). No association was observed for low (n = 212) versus not low (n = 635) decision latitude at work and DAS28-CRP remission at 3 (OR 0.84, 95%CI 0.54–1.31), 12 (OR 0.81, 95%CI 0.56–1.16), or 60 (OR 1.37, 95%CI 0.94–2.01) months. Conclusion: In a country with general access to healthcare, psychosocial vulnerability does not influence the likelihood of achieving remission in early RA.

KW - Antirheumatic Agents/therapeutic use

KW - Arthritis, Rheumatoid/drug therapy

KW - C-Reactive Protein

KW - Cohort Studies

KW - Humans

KW - Remission Induction

KW - Severity of Illness Index

KW - Social Support

KW - Sweden/epidemiology

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U2 - 10.1186/s13075-022-02892-w

DO - 10.1186/s13075-022-02892-w

M3 - Article

C2 - 35999588

AN - SCOPUS:85136397110

SN - 1478-6354

VL - 24

SP - 203

JO - Arthritis Research and Therapy

JF - Arthritis Research and Therapy

IS - 1

M1 - 203

ER -

Neither low social support nor low decision latitude at work is associated with disease remission among patients with rheumatoid arthritis: results from the Swedish EIRA study

Abstract

Bibliographical note

Other keywords

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