AB1720-PARE NEGATIVE ILLNESS BELIEF ASSOCIATED WITH MORE ACTIVE DISEASE ACTIVITY AND POORER FUNCTION IN THAI PATIENTS WITH ANKYLOSING SPONDYLITIS AND PSORIATIC ARTHRITIS

Abstract

BackgroundRegarding the common sense self-regulatory model[1], illness beliefs plays an essential role in both physical and psychological adjustment to illness. There were few studies about the value of illness representations in the outcome of spondyloarthritis[2]and no study in Thailand.ObjectivesTo explore the illness perception and their associated factors in AS and PsA patients.MethodsThis was a cross-sectional study. Spondyloarthritis patients visiting at Siriraj Hospital for treatment were recruited between 27 April 2021 and 31 October 2022. They were invited to fill out the Thai version of brief Illness Perception Questionnaire(BIPQ) [total range 0 (no or best)-80(worst)], the medication taking behavior measure for Thai patients(MTB) [range 4(low adherence)-24 (high adherence)], demographic data, Ankylosing Spondylitis Disease Activity Score(ASDAS), and Bath Ankylosing Spondylitis Disease Activity Index(BASFI) were collected. The variables were associated with total BIPQ were computed by linear regression.ResultsA total of 132 patients with 73(55%) male, mean(SD) age of 49(12) years, median(IQR) disease duration of 11(14) years, median ASDAS of 1.7(1.2), median BASFI of 0.9(2.2), median BIPQ of 26(12), and mean MTB of 23.2(1.0) were recruited. The BIPQ was significantly positive associated with ASDAS and BASFI in multivariate analysis. Consequences, timeline, identity, illness concern, and emotional representation were positively associated with ASDAS while identity and emotional representation were positively associated with BASFI (Table 1). Positive emotional representative in BIPQ was associated with higher MTB (p<0.05).ConclusionThe patients with positive illness perception were associated with better function, lower disease activity, and higher medication adherence. The goal of treatment should be inactive or low disease activity and normalized function as soon as possible may lead to positive illness belief and psychological strength, or vice versa. The positive illness belief may maintain the good health outcome. A longitudinal study is needed to support this association.Table 1.The association of the brief illness perception and disease activity, and functionUnstandardized B coefficientItemTotalASDAS1BASFI21.Consequences2(3)0.233#0.126*2.Timeline8(5)0.071#0.037*3. Personal control5(4)-0.0560.008*4. Treatment control1(2)0.0140.019*5. Identity1(2)0.123#0.164*6. Illness concern2(2)0.097#0.055*7. Coherence2(3)-0.0080.008*8. Emotional representation2 (2)0.101#0.154#*Total score26 (12)0.047#0.033#*Abbreviations = ASDAS, Ankylosing Spondylitis Disease Activity Score; BASFI, Bath Ankylosing Spondylitis Functional Index; B,1adjusted for disease duration;2adjusted for disease duration and ASDAS; * ASDAS was significantly associated with BASFI with p-value <0.0001;#p<0.05Total values are in median (IQR) unless otherwise stated.