Driving difficulties in patients with axial spondyloarthritis: Results from the Scotland Registry for Ankylosing Spondylitis

Lakrista Morton, Gary Macfarlane, Gareth Jones, Karen Walker-Bone, Rosemary Hollick* (Corresponding Author)

*Corresponding author for this work

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Abstract

Objectives: To describe the driving difficulties experienced by individuals with axial spondyloarthritis (axSpA), and characterise associated clinical and sociodemographic features, and impact on work.

Method: The Scotland Registry for Ankylosing Spondylitis (SIRAS) is a cohort study of patients with a clinical diagnosis of axSpA. Baseline information was collected on clinical and patient-reported measures, and work participation measures (Work Productivity and Activity Impairment Questionnaire: Specific Health Problem (WPAI: SHP)). Patient-rated difficulties with nine driving tasks were used in a factor analysis, and relationships between driving difficulty and work participation investigated.

Results: 718 patients provided data for analysis, of which 642 (89%) had some difficulty with at least one driving task and 72 (10%) had some difficulty with all nine tasks. Three domains of driving difficulty were identified: dynamic driving scenarios, crossing traffic, and the physical act of driving. Chronic widespread pain, knee and back pain, fatigue, high disease activity and anxiety/depression were significantly associated with reporting driving difficulties across all three domains, particularly the physical act of driving. After adjusting for socio-demographic, disease activity, physical and mental health, driving difficulties in each domain were associated with a 2-3 times increased likelihood of restricted work productivity and with an increased risk of sickness absence in the past seven days.

Conclusion: Driving difficulties are common in individuals with axSpA and impact on work, even after adjusting for clinical status. Improving understanding and awareness of driving disability will help direct advice and resources to enable individuals to remain independent and economically active.
Original languageEnglish
Pages (from-to)1541-1549
JournalArthritis Care & Research
Volume74
Issue number9
Early online date18 Mar 2021
DOIs
Publication statusPublished - Sept 2022

Bibliographical note

Acknowledgements
The authors thank all of the clinicians and research nurses who facilitated recruitment and data collection, and the SIRAS steering committee in particular, especially Professor Roger Sturrock (chair) and Dr David Marshall (vice‐chair). The authors also thank the SIRAS coordinating centre study team, particularly Elizabeth Ferguson‐Jones, Giles O'Donovan, Nabi Moaven‐Hashemi, and Flora Joyce.
Funding: AbbVie and Pfizer financially supported the Scotland Registry for Ankylosing Spondylitis (SIRAS). AbbVie and Pfizer had no role in the study design or in the collection, analysis, or interpretation of the data, the writing of the manuscript, or the decision to
submit the manuscript for publication. Publication of this article was not contingent upon approval by AbbVie or by Pfizer. LM is funded through the Medical Research Council/Versus Arthritis Centre for Musculoskeletal Health and Work (Versus Arthritis Grant No. 20665).

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