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. 2016 Jan 19;2(1):e000166.
doi: 10.1136/rmdopen-2015-000166. eCollection 2016.

Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt- a national health survey

Jaime C Branco  1 , Ana M Rodrigues  2 , Nélia Gouveia  3 , Mónica Eusébio  4 , Sofia Ramiro  5 , Pedro M Machado  6 , Leonor Pereira da Costa  7 , Ana Filipa Mourão  8 , Inês Silva  9 , Pedro Laires  10 , Alexandre Sepriano  11 , Filipe Araújo  12 , Sónia Gonçalves  13 , Pedro S Coelho  14 , Viviana Tavares  15 , Jorge Cerol  4 , Jorge M Mendes  14 , Loreto Carmona  16 , Helena Canhão  17 ; EpiReumaPt study group
Affiliations

Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt- a national health survey

Jaime C Branco et al. RMD Open. .

Abstract

Objectives: To estimate the national prevalence of rheumatic and musculoskeletal diseases (RMDs) in the adult Portuguese population and to determine their impact on health-related quality of life (HRQoL), physical function, anxiety and depression.

Methods: EpiReumaPt is a national health survey with a three-stage approach. First, 10 661 adult participants were randomly selected. Trained interviewers undertook structured face-to-face questionnaires that included screening for RMDs and assessments of health-related quality of life, physical function, anxiety and depression. Second, positive screenings for ≥1 RMD plus 20% negative screenings were invited to be evaluated by a rheumatologist. Finally, three rheumatologists revised all the information and confirmed the diagnoses according to validated criteria. Estimates were computed as weighted proportions, taking the sampling design into account.

Results: The disease-specific prevalence rates (and 95% CIs) of RMDs in the adult Portuguese population were: low back pain, 26.4% (23.3% to 29.5%); periarticular disease, 15.8% (13.5% to 18.0%); knee osteoarthritis (OA), 12.4% (11.0% to 13.8%); osteoporosis, 10.2% (9.0% to 11.3%); hand OA, 8.7% (7.5% to 9.9%); hip OA, 2.9% (2.3% to 3.6%); fibromyalgia, 1.7% (1.1% to 2.1%); spondyloarthritis, 1.6% (1.2% to 2.1%); gout, 1.3% (1.0% to 1.6%); rheumatoid arthritis, 0.7% (0.5% to 0.9%); systemic lupus erythaematosus, 0.1% (0.1% to 0.2%) and polymyalgia rheumatica, 0.1% (0.0% to 0.2%). After multivariable adjustment, participants with RMDs had significantly lower EQ5D scores (β=-0.09; p<0.001) and higher HAQ scores (β=0.13; p<0.001) than participants without RMDs. RMDs were also significantly associated with the presence of anxiety symptoms (OR=3.5; p=0.006).

Conclusions: RMDs are highly prevalent in Portugal and are associated not only with significant physical function and mental health impairment but also with poor HRQoL, leading to more health resource consumption. The EpiReumaPt study emphasises the burden of RMDs in Portugal and the need to increase RMD awareness, being a strong argument to encourage policymakers to increase the amount of resources allocated to the treatment of rheumatic patients.

Keywords: Epidemiology; Fibromyalgis/Pain Syndromes; Low Back Pain; Osteoarthritis; Spondyloarthritis.

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Figures

Figure 1
Figure 1
Flowchart of recruitment in the EpiReumaPt Study. RMD, rheumatic and musculoskeletal disease; MSK, musculoskeletal disease.
Figure 2
Figure 2
Prevalence of RMDs, stratified by age group. RMD, rheumatic and musculoskeletal disease.
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