Exploring factors influencing patient activation in Saudi rheumatoid arthritis patients: A Nationwide Cross-Sectional Survey-Results from the COPARA study.

OBJECTIVES: To evaluate patient activation in rheumatoid arthritis (RA) patients using patient activation measure 13 (PAM-13) on a national level in Saudi Arabia. METHOD: A national survey was administered across multiple centers in Saudi Arabia. Patient activation was assessed using the PAM-13. The Compliance Questionnaire for Rheumatology (CQR) and the RA Impact of Disease (RAID) tool were also administered. The data from the survey were analyzed, and the results were stratified based on activation level. All factors affecting patient activation were explored and reported. RESULTS: A total of 1241 participants were included. Most of the patients were females (85%), the mean age was 47 (±14), and most patients lived in the central region (47%). The mean (±standard deviation) patient activation score was 578.7 (±13.0). Patient activation was affected by multiple factors: demographic characteristics, such as education, with a beta value of 1.11 (95% confidence interval [CI] 0.64 ̶1.58, p < .001). Higher CQR scores were associated with higher activation levels, with a beta value of 2.61 (95% CI 0.80 ̶4.44, p = .005), and higher RAID scores were associated with lower activation levels, with a beta value of 3.13 (95% CI 1.36 ̶4.91, p = .001). CONCLUSIONS: Patient activation was affected by several demographic characteristics and the impact of RA. A higher activation may improve compliance. Future longitudinal studies are required to confirm these findings and should explore the underlying mechanism of these effects.

Exploring Impact of Multidisciplinary Care on Patient Activation in Saudi Rheumatoid Arthritis Patients: A Cross-Sectional Survey-Extended Results from the COPARA National Project.

Introduction: Multidisciplinary setting in healthcare provide positive patient outcomes. Objective: To evaluate the impact of specialized rheumatology clinics (multidisciplinary settings) on the activation and engagement of rheumatoid arthritis (RA) patients. Material and Methods: This cross-sectional survey assessed patient activation using the patient activation measure-13. Participants attending Specialized Rheumatology Clinics (SRC multidisciplinary clinics) were compared with age- and sex-matched patients attending Standard of Care (SOC). The study was observational in nature, assessing several demographic and therapeutic options and their relation to the clinical setting and patient activation. Results: This study included 117 SRC matched RA patients with 117 SOC. The majority of the included patients were female (n=211, 90.2%), >40 years of age (n=177, 75.6%), and had intermediate-to-high education (n=147, 62.8%). Patients in the SRC were also more likely to have activation levels 3 and 4 with an odds ratio of 3.194 (95% confidence interval [CI] 1.835-5.562, p<0.001). In addition, SRC participants were more likely to be in levels 3 and 4 activation, even after adjustment for confounding variables, with an adjusted odds ratio of 2.401 (95% CI 1.121-4.758, p=0.012) and 2.175 (95% CI 1.127-4.196, p=0.020), respectively. Conclusion: Establishing SRC for RA patients seems to have a positive impact on patient activation and engagement and adds to the previously explored benefits of multidisciplinary care in chronic disease management.

A rare association: Obesity hypoventilation syndrome with myasthenia gravis and systemic lupus erythematosus, case report.

Background: Shrinking lung syndrome (SLS) is an uncommon complication of systemic lupus erythematosus (SLE) that has also been seen in other autoimmune diseases and is linked with a high risk of acute or chronic respiratory failure. Alveolar hypoventilation in the presence of obesity-hypoventilation syndrome, systemic lupus erythematosus (SLE), and myasthenia gravis (MG) is uncommon and poses a diagnostic and therapeutic challenge. Case report: We reported a 33-year-old female patient from Saudi Arabia who suffered from obesity, bronchial asthma, newly diagnosed essential hypertension, type 2 diabetes mellitus, with recurrent acute alveolar hypoventilation, secondary to obesity hypoventilation syndrome and mixed autoimmune disease (systemic lupus erythematosus and myasthenia gravis), based on the correct constellation of clinical findings and laboratory evidence. Conclusion: The interesting aspect of this case report: is the presentation of the overlap of obesity hypoventilation syndrome and shrinking lung syndrome due to systemic lupus erythematosus with generalized and respiratory muscle dysfunction due to myasthenia gravis with good outcomes after therapy.

Exploring Factors Influencing Medication Compliance in Saudi Rheumatoid Arthritis Patients: A Nationwide Cross-Sectional Survey - Results from the COPARA Study.

Purpose: Compliance is essential to achieve treatment goals in rheumatoid arthritis (RA) patients. The current study evaluated compliance and related factors in a large and diverse population. Patients and Methods: Patients with RA who received active treatment were invited to participate in an online survey. The Arabic versions of the 5-Item Compliance Questionnaire for Rheumatology (ACQR-5) and the RA Impact of Disease (RAID) were used to measure compliance and disability, respectively. The patients were sub-grouped based on background disease-modifying anti-rheumatic drugs (DMARDs). Variables associated with high compliance were selected for the logistic regression analysis. Results: A total of 1241 patients completed the survey and were included in the final analysis. Of those, 1055 (85%) were females with a mean (±SD) age and disease duration of 47.14 ± 13.71 and 8.77 ± 7.43 years, respectively. The mean RAID was 4.4±2.58, with 980 (79%) having an unacceptable level state. Patients with an unacceptable RAID level had a lower compliance rate (78.8% vs 85.8%, p = 0.001). Demographics associated with high compliance were female sex and increased age, with reported odds ratios of 1.018 (95% CI: 1.007-1.028) and 1.464 (95% CI: 1.016-2.108), respectively. Compliance was similar between patients on Janus kinase inhibitors or biological DMARDs (88.14% vs 80.83%, p = 0.17), between monotherapy, double therapy, or triple therapy recipients (80% vs 82.23% vs 81.32%, p = 0.665), and between patients receiving injectable and oral therapy (77.32% vs 81.14%, p = 0.246). Conclusion: A high compliance level was observed in this population, with patient demographics influencing compliance rather than the medication type or route of administration. Interventional studies should focus on the of high-risk patients identified in this study.

Fibromyalgia in Health Care Worker During COVID-19 Outbreak in Saudi Arabia.

Background: In the face of the contemporary COVID-19 pandemic, health service providers have emerged as the most at-risk individuals who are likely to contract the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Aim: To measure the prevalence of fibromyalgia (FM) during COVID outbreak among health workers in Saudi Arabia using FiRST and LFESSQ tool. Methods: The study employed a cross-sectional methodology to explore the prevalence of Fibromyalgia among health workers at different health care settings in Saudi Arabia. The assessment of the prevalence of fibromyalgia among health worker was determined by using the Fibromyalgia Rapid Screening Tool (FiRST) and London Fibromyalgia Epidemiological Study Screening Questionnaire (LFESSQ) questionnaires. Descriptive statistics were used to summarize the data. Results: The sample size included 992 participants. The prevalence of fibromyalgia using FiRST and LFESSQ was 12.6 and 19.8%, respectively. In this study, the prevalence of fibromyalgia was higher in females when compared to males. Most of the respondents have Vitamin D deficiency. The relationship of fibromyalgia was significantly associated with the participants who worked during an outbreak, who covered COVID-19 inpatient, covered in-hospital on call and in area quarantine. Conclusion: The study's findings demonstrate that the prevalence of Fibromyalgia among health service providers during the current COVID-19 pandemic is considerably higher and that there are potential interventions that may be employed to mitigate the prevalence of the infection during the COVID-19 crisis.

Clinical characteristics of asymptomatic and symptomatic COVID-19 patients in the Eastern Province of Saudi Arabia.

BACKGROUND: The first case of COVID-19 infection in Saudi Arabia was reported in Qatif on March 2nd, 2020. Here, we describe the clinical characteristics of the initial COVID-19 patients in that area. METHODS: This is an observational study describing the clinical presentation, radiographic and laboratory data of COVID-19 cases. RESULTS: From March 1st, 2020 to April 5th, 2020 we identified a total of 82 adult COVID-19 patients. The median age of the patients was 50 years, with a range of 30 to 60 years and most of patients were female 54 (65.9%). Of all the patients, 29 (35.4%) were contacts and 43 (52.4%) were returning travelers, mainly from Iraq (65% of the total returning travelers). Comorbidities were present in 50% of patients, G6PD deficiency in 33%, hypertension in 27%, and diabetes mellitus in 26%. Chest radiographs were abnormal in 46% of symptomatic and 15.5% of asymptomatic patients (P value = 0.0035). Of all patients, 4 (4.87%) required intensive care admission. There was no significant difference in time to negative RT-PCR with mean days to negativity of 13.6 and 16.9 for asymptomatic and symptomatic group, respectively (P value = 0.42). CONCLUSIONS: In the initial Epicenter of the COVID-19 in Saudi Arabia, the majority of the patients were asymptomatic and were returning travelers. Comorbidities were present in nearly half of the patients.