Objectives to analyse socioeconomic and demographic characteristics at baseline in two cohorts, enrolled 10 years apart and examine possible changes between the cohorts and relate data to contemporary socioeconomic changes in the general population (GP).
Methods In 1996-98, 320 patients with early RA (TIRA-1) were recruited from 10 rheumatology units in Sweden and followed over 8 years. A similar cohort was recruited 10 years later and 467 patients (TIRA-2) were enrolled 2006-09. At baseline, patients completed a comprehensive questionnaire with demographic data, marital status, educational level, employment status, EQ-5D and EQ-VAS. Data were compared between the cohorts and comparisons were made with the GP, for men and women separately and for different age groups. Data for GP were derived from Statistics Sweden and EQ-5D values were derived from 2 Swedish population surveys conducted 1999 and 2006.
Results In total, 317 patients (99%) in TIRA-1 and 436 (93%) in TIRA-2 completed baseline questionnaires. Patients in the 2006-09 cohort were older, 58 vs 56 years (p=0.050). Gender proportions were similar, 67% women. Women were younger than men, 55 vs 59 in TIRA-1 (p=0.021) and 57 vs 61 in TIRA-2 (p=0.005). Approximately 73% of the patients were living with a partner, in both cohorts and in the GP. In line with increasing formal education in the GP, educational level was higher in TIRA-2 compared to TIRA-1, but was still lower in both cohorts, compared to the GP. Women had higher education than men in both groups. Education was associated to age, younger patients having higher levels of education (p<0.001). In both cohorts, fewer years of formal education was associated with increased disability pension (DP) (p<0.001) and increased sick leave (p=0.001). Levels of sick leave were higher in TIRA-1, with 50% being on sick leave compared to 37% in TIRA-2 (p=0.009). By contrast, levels of DP were higher in TIRA-2, 16% vs 10% in TIRA-1, due to increasing number of women with DP. In TIRA-1, 9% of women had DP, compared to 17% in TIRA-2 (p=0.037). Total loss of productivity, was however, rather similar in the two cohorts. A similar development in sick leave and DP was seen in the GP. In both cohorts, older patients were more likely to be on sick leave or have DP (p<0.001). Quality of life, measured by EQ-5D scores, were similar for men in both cohorts, 0.56, but women scored 0.61 in the 1996-98 cohort and 0.54 in the 2006-09 cohort (p=0.007) indicating worse wellbeing in TIRA-2. EQ-VAS scores were, in a similar way as EQ-5D, lower for women in TIRA-2 compared to TIRA-1. Scores for RA patients were lower in all age groups compared to the population average. In both cohorts, patients with low levels of EQ-5D and EQ-VAS were more likely to be on sick leave or have DP.
Conclusions Patients in TIRA-2 were older and better educated. Loss of productivity was similar in the cohorts. Sick leave decreased but DP increased. Similar trends were seen in the GP. EQ-5D was significantly lower for RA patients in TIRA-2 compared to TIRA-1 and also compared to the population average, and this was most pronounced in women.
Disclosure of Interest None Declared