The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study

Gary J Macfarlane; Rosemary J Hollick; Eva-Maria Bachmair; R Stuart Anderson; Karen Forrest Keenan; Peter Murchie; Kevin Stelfox; Gareth T Jones; Lakrista Morton; Marcus Beasley; Maureen Heddle; Daniel Whibley

doi:10.1093/rheumatology/keab374

The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study

Gary J Macfarlane^* (Corresponding Author), Rosemary J Hollick, Eva-Maria Bachmair, R Stuart Anderson, Karen Forrest Keenan, Peter Murchie, Kevin Stelfox, Gareth T Jones, Lakrista Morton, Marcus Beasley, Maureen Heddle, Daniel Whibley

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

6 Citations (Scopus)

Abstract

OBJECTIVE: To quantify the change in quality of life, disease-specific indicators, health, and lifestyle before and during the COVID19 pandemic amongst people with musculoskeletal diagnoses and symptoms.

METHODS: We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place.

RESULTS: 1054 people took part in the study (596 axSpA, 162 PsA, 296 regional pain). In comparison to their previous (pre-pandemic) assessment, there was an age-adjusted significant, small, decrease in quality of life measured by EQ-5D (-0.020 95% CI (-0.030, -0.009)) overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender, and deprivation.

CONCLUSION: Important lessons include focussing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.

Original language	English
Pages (from-to)	SI13-SI24
Number of pages	12
Journal	Rheumatology
Volume	60
Issue number	SI
Early online date	21 Apr 2021
DOIs	https://doi.org/10.1093/rheumatology/keab374
Publication status	Published - Oct 2021

Keywords

COVID19
axial spondyloarthritis
psoriatic arthritis
pain
quality of life

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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VC The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
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Macfarlane, G. J., Hollick, R. J., Bachmair, E-M., Anderson, R. S., Keenan, K. F., Murchie, P., Stelfox, K., Jones, G. T., Morton, L., Beasley, M., Heddle, M., & Whibley, D. (2021). The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study. Rheumatology, 60(SI), SI13-SI24. https://doi.org/10.1093/rheumatology/keab374

Macfarlane, GJ , Hollick, RJ, Bachmair, E-M, Anderson, RS, Keenan, KF , Murchie, P , Stelfox, K , Jones, GT , Morton, L , Beasley, M, Heddle, M & Whibley, D 2021, 'The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study', Rheumatology, vol. 60, no. SI, pp. SI13-SI24. https://doi.org/10.1093/rheumatology/keab374

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title = "The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study",

abstract = "OBJECTIVE: To quantify the change in quality of life, disease-specific indicators, health, and lifestyle before and during the COVID19 pandemic amongst people with musculoskeletal diagnoses and symptoms.METHODS: We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place.RESULTS: 1054 people took part in the study (596 axSpA, 162 PsA, 296 regional pain). In comparison to their previous (pre-pandemic) assessment, there was an age-adjusted significant, small, decrease in quality of life measured by EQ-5D (-0.020 95% CI (-0.030, -0.009)) overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender, and deprivation.CONCLUSION: Important lessons include focussing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.",

keywords = "COVID19, axial spondyloarthritis, psoriatic arthritis, pain, quality of life",

author = "Macfarlane, {Gary J} and Hollick, {Rosemary J} and Eva-Maria Bachmair and Anderson, {R Stuart} and Keenan, {Karen Forrest} and Peter Murchie and Kevin Stelfox and Jones, {Gareth T} and Lakrista Morton and Marcus Beasley and Maureen Heddle and Daniel Whibley",

note = "Funding This work was supported by Versus Arthritis [Grant Number: 20748] and the British Society for Rheumatology. The funding for the original studies included were from Versus Arthritis (MAmMOTH) and the British Society for Rheumatology (BSRBR-AS and BSR-PsA). Daniel Whibley is supported by a Versus Arthritis Foundation Fellowship [Grant Number 21742] Acknowledgements We are grateful to help from staff at the National Ankylosing Spondylitis Society and specifically to patient partners Lynne Laidlaw (for help with designing questionnaire) and Susan Davis (for commenting on the manuscript). The authors do not report any conflicts of interest. GJM conceived the idea for the study and all authors were involved in the detailed planning. MH, KK, EM-B and MB were responsible for obtaining ethics and research governance approvals. MB undertook the analysis which was independently verified by GTJ. GJM, with input from MB, drafted the manuscript, and all authors contributed important intellectual content via written comments. We thank Linda Dean for comments on the manuscript. Data Availability Statement The data within the article which relate to the collection of BSR register data are owned by the BSR – access to these data are subject to application being made to the BSR: Registers (rheumatology.org.uk) . For other data in the article, application can be made for access to the data by contacting the corresponding author.",

year = "2021",

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doi = "10.1093/rheumatology/keab374",

language = "English",

volume = "60",

pages = "SI13--SI24",

journal = "Rheumatology",

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publisher = "OXFORD UNIV PRESS INC",

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TY - JOUR

T1 - The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms

T2 - the CONTAIN study

AU - Macfarlane, Gary J

AU - Hollick, Rosemary J

AU - Bachmair, Eva-Maria

AU - Anderson, R Stuart

AU - Keenan, Karen Forrest

AU - Murchie, Peter

AU - Stelfox, Kevin

AU - Jones, Gareth T

AU - Morton, Lakrista

AU - Beasley, Marcus

AU - Heddle, Maureen

AU - Whibley, Daniel

N1 - Funding This work was supported by Versus Arthritis [Grant Number: 20748] and the British Society for Rheumatology. The funding for the original studies included were from Versus Arthritis (MAmMOTH) and the British Society for Rheumatology (BSRBR-AS and BSR-PsA). Daniel Whibley is supported by a Versus Arthritis Foundation Fellowship [Grant Number 21742] Acknowledgements We are grateful to help from staff at the National Ankylosing Spondylitis Society and specifically to patient partners Lynne Laidlaw (for help with designing questionnaire) and Susan Davis (for commenting on the manuscript). The authors do not report any conflicts of interest. GJM conceived the idea for the study and all authors were involved in the detailed planning. MH, KK, EM-B and MB were responsible for obtaining ethics and research governance approvals. MB undertook the analysis which was independently verified by GTJ. GJM, with input from MB, drafted the manuscript, and all authors contributed important intellectual content via written comments. We thank Linda Dean for comments on the manuscript. Data Availability Statement The data within the article which relate to the collection of BSR register data are owned by the BSR – access to these data are subject to application being made to the BSR: Registers (rheumatology.org.uk) . For other data in the article, application can be made for access to the data by contacting the corresponding author.

PY - 2021/10

Y1 - 2021/10

N2 - OBJECTIVE: To quantify the change in quality of life, disease-specific indicators, health, and lifestyle before and during the COVID19 pandemic amongst people with musculoskeletal diagnoses and symptoms.METHODS: We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place.RESULTS: 1054 people took part in the study (596 axSpA, 162 PsA, 296 regional pain). In comparison to their previous (pre-pandemic) assessment, there was an age-adjusted significant, small, decrease in quality of life measured by EQ-5D (-0.020 95% CI (-0.030, -0.009)) overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender, and deprivation.CONCLUSION: Important lessons include focussing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.

AB - OBJECTIVE: To quantify the change in quality of life, disease-specific indicators, health, and lifestyle before and during the COVID19 pandemic amongst people with musculoskeletal diagnoses and symptoms.METHODS: We undertook an additional follow-up of two existing UK registers involving people with axial spondyloarthritis (axSpA) or psoriatic arthritis (PsA) and participants in a trial in the UK who had regional pain and were identified at high risk of developing chronic widespread pain. Participants completed the study questionnaire between July and December 2020, throughout which time there were public health restrictions in place.RESULTS: 1054 people took part in the study (596 axSpA, 162 PsA, 296 regional pain). In comparison to their previous (pre-pandemic) assessment, there was an age-adjusted significant, small, decrease in quality of life measured by EQ-5D (-0.020 95% CI (-0.030, -0.009)) overall and across all population groups examined. This was primarily related to poorer mental health and pain. There was a small increase in fibromyalgia symptoms, but a small decrease in sleep problems. There was a small deterioration in axSpA disease activity, and disease-specific quality of life and anxiety in PsA participants. Predictors of poor quality of life were similar pre- and during the pandemic. The effect of lockdown on activity differed according to age, gender, and deprivation.CONCLUSION: Important lessons include focussing on addressing anxiety and providing enhanced support for self-management in the absence of normal health care being available, and awareness that all population groups are likely to be affected.

KW - COVID19

KW - axial spondyloarthritis

KW - psoriatic arthritis

KW - pain

KW - quality of life

U2 - 10.1093/rheumatology/keab374

DO - 10.1093/rheumatology/keab374

M3 - Article

C2 - 34009314

VL - 60

SP - SI13-SI24

JO - Rheumatology

JF - Rheumatology

SN - 1462-0324

IS - SI

ER -

The effect of COVID19 public health restrictions on the health of people with musculoskeletal conditions and symptoms: the CONTAIN study

Abstract

Keywords

UN SDGs

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