THE IMPACT OF FIBROMYALGIA ON MENTAL HEALTH, QUALITY OF LIFE AND COPING STRATEGIES IN RHEUMATOID ARTHRITIS PATIENTS

Background: Incidence of fibromyalgia (FM) in rheumatoid arthritis (RA) patients is considerably higher than in the general population (1). Previous research has shown this comorbidity to have associations with greater RA disease activity, poorer quality of life and greater prevalence of mental health conditions, notably anxiety and depression (2,3). Due to these observed negative impacts of FM, research into the lived experience of affected patients, including the coping strategies adopted, holds substantial value for improving care. Objectives: We aim to evaluate the influence of FM diagnosis and potential sociodemographic factors on the quality of life, mental health and coping strategies adopted by RA patients. Methods: This cross-sectional study used data collected from 127 RA patients recruited from UK based rheumatology outpatient clinics between December 2019 and September 2022 who have recently started/switched to a new DMARD. Data collected included sociodemographic data including age, gender, ethnicity, income status and education level were collected. Data was also collected for FM diagnosis, quality of life (EQ5D), anxiety (GAD-7), and depression (PHQ-9), and pain catastrophising using a single item Pain Catastrophising Scale. The cognitive and behavioural responses to symptoms questionnaire (CBRQ) was utilised to measure the use of coping strategies; this consists of four cognitive subscales (fear avoidance, damage beliefs, symptom focusing, embarrassment avoidance) and two behavioural subscales (all or nothing, resting avoidance). Logistic regression analysis investigated sociodemographic variables associated with meeting FM criteria. Multiple linear regression and logistic regression was adopted to investigate FM as a predictor of quality of life, anxiety, depression and coping strategies whilst adjusting for sociodemographic factors. Results: A total of 41 patients were identified as meeting FM classification criteria and were compared with 83 patients without FM. None of the sociodemographic variables assessed (age, gender, ethnicity, education, social deprivation) were significantly related to meeting FM criteria versus not using logistic regression. Linear regression using a base model including FM, age, gender and ethnicity was adopted (Table 1). Education and social deprivation were not found to be confounding factors and were removed. Here FM was identified as significantly associated with worse quality of life (EQ5D) and mental health (PHQ-9, GAD-7). Furthermore, FM was significantly associated with greater pain catastrophising, fear avoidance, damage beliefs, symptom focusing, embarrassment avoidance and resting avoidance. Conclusion: This study identifies that FM diagnosis has a negative impact on quality of life, mental health, and also associated with negative coping strategies and beliefs. These results indicate a need to further support patients with RA meeting FM criteria to reduce the impact on their quality of life, potentially through interventions addressing mental health and coping strategies. REFERENCES: [1] Duffield, S.J. et al. Rheumatology 57.8 (2018): 1453 [2] Provan, S.A. et al. Clinical and Experimental Rheumatology 37 (2019): 58 [3] Birtane, M. et al. Clinical Rheumatology 26.5 (2007): 679 Acknowledgements: NIL. Disclosure of Interests: Tisa Manandhar: None declared, Melissa Sweeney: None declared, Lewis Carpenter Pfizer, Savia de Souza: None declared, Emma Caton: None declared, James Galloway AbbVie Celgene, Chugai, Gillead, Janssen, Eli Lilly, Pfizer, Roche, UCB, Andrew Cope: None declared, Elena Nikiphorou: None declared, Bruce Kirkham: None declared, Rona Moss-Morris: None declared, Sam Norton Janssen, Pfizer, Lucy Zhao: None declared.