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AB0295 The Relationship Between Formal Education Level and Delay in Diagnosis and Disease Activity in Patients with Rheumatoid Arthritis
  1. M.F. Oksuz1,
  2. F. Yıldırım2,
  3. A.B. Sahin2,
  4. A. Gocken2,
  5. A.N. Tufan1,
  6. N. Orucoglu1,
  7. E. Dalkilic1,
  8. Y. Pehlivan1
  1. 1Rheumatology
  2. 2Internal Medicine, Uludag Universty School of Medicine, Bursa, Turkey


Background Rheumatoid arthritis (RA) is a chronic inflammatory disease which can cause serious joint deformity and loss of manpower in situation of delay in diagnosis and treatment. In recent years, for many diseases, the effects of the factors such as formal education level, socio-economic status on the activity and the course of the diseases have been studied

Objectives In this study we aimed to analyze the effect of formal education level on the disease activity and course of the disease in patients with RA in Turkish population.

Methods The patients, who were followed up in our outpatient clinic, were included consecutively. The patients were performed the multidimensional health assessment questionnaire (MDHAQ) including physical function, pain, global assessment of the patients. Tender and swollen joint counts, global assessment, visual analogue scale (VAS), routine assessment of patient index data 3 (RAPID3), disease activity score 28 (DAS28), demographic data, formal education level, past treatment, clinical and laboratory data of the patients were recorded. In the analysis of correlation between formal education level and delay in diagnosis and disease activity, spearman correlation test and multivariate linear regression analysis were used

Results In our study 339 patients with RA were included (mean age 52.84±11.29; mean of disease duration 10 years; 80.5% female [n: 273], 19.5% male [n: 66]). The data of formal education level of the patients are in Table 1. In multivariate linear regression analysis, the correlation coefficient (r) was 0.32 and coefficient of determination (r2) was 0.1. As a result physical function on a multidimensional health assessment questionnaire (MDHAQ-FN) (t =2.69, p=0.008) and formal education level (t = -4.69 p<0.001) were identified as independent predictors for delay in diagnosis.

Conclusions In our study, it was found that there was a significant delay in diagnosis of rheumatoid arthritis. The factor, having most powerful relationship with delay in diagnosis was low level of formal education. It also found that delay in diagnosis was associated with loss of functionality. Improving the educational level of our society and increasing the awareness about RA are so important to prevent delay in diagnosis whereby to prevent the loss of functionality relating to the disease


  1. Theodore Pincus, Patient Questionnaires and Formal Education as More Significant Prognostic Markers than Radiographs or Laboratory Tests for Rheumatoid Arthritis Mortality Limitations of a Biomedical Model to Predict Long-Term Outcomes

  2. C Bengtsson, B Nordmark, L Klareskog, I Lundberg, L Alfredsson, the EIRA study group, Ann Rheum Dis 2005;64:1588–1594

Disclosure of Interest None declared

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