Background Inspite of the large amount of scientific studies investigating the problem of pain in rheumatoid arthritis (RA), the question why patients with equally high indices of disease activity are experiencing different levels of pain, remains unsolved.
Objectives To identify the influence of the choice of different coping strategies for pain intensity and frequency of NSAID usage in patients with a high activity of RA.
Methods The cross – sectional survey included 124 patients with RA (male to female ratio 4,4:1), mean age 49,4 [44; 56] years, mean duration of disease ranged from 3 months to 41 years (10,8 [3,5;13]). RA diagnosis based on ACR/EULAR criteria of 2010. Pain was recorded using a visual analog scale (VAS). Chronic pain Coping Questionnaire was used in determing coping strategies. Patients were divided into 2 groups: the 1st group included patients that took NSAID daily, the 2nd group – patients that used NSAID every 2-3 days or less. DAS 28 in both groups corresponded to the high activity of RA (5,65 [5,15; 6,4] vs 5,16 [4,4; 5,64]), p<0,05. The significance of differences was determined by Mann – Whitney test, differences were considered significant at p<0,005.
Results Opposite coping behaviour was revealed among patients of two groups: patients of the 1st group used maladaptive coping strategies significantly more often than patients from the 2nd group (70% vs 37,7%, p=0,002), and visa versa, patients from the 2nd group were more focused on adaptive coping (18% vs 53,3%, p=0,0005). Patients from the 1st group had higher pain intensity scores than patients from the 2nd group according to the VAS scale (50 [40; 65] vs 40 [30; 50], p=0,002).
Conclusions The choice of coping strategies that make patients with a high RA activity affects the intensity of pain and the frequency of NSAID usage. Thus, patients that were focused on maladaptive coping, experienced significantly higher levels of pain intensity and took NSAID more often than patients that used adaptive coping strategies (p<0.05). The data suggests the necessity of the cognitive - behavioral therapy implementation, that could help patients in modifying their maladaptive behavior, to the complex treatment of patients with RA.
Disclosure of Interest None declared