EFFECT OF SOCIAL DEPRIVATION ON DISEASE SEVERITY AND OUTCOME IN PATIENTS WITH RHEUMATOID-ARTHRITIS

Objective-Social deprivation is now recognised to have an important im pact on morbidity and mortality. This study sought to ascertain the ef fect of deprivation, if any, on disease severity, functional disabilit y, and outcome in rheumatoid patients in Glasgow. Methods-814 patients with rheumatoid arthritis (RA) were assessed for clinical, functional , and laboratory indices of disease activity. Deprivation categories f or individual patients were determined using the Carstairs index. Five year follow up is available for 440 patients. Results-The study popul ation of RA patients Live largely in the most deprived areas, Patients from deprived areas have significantly poorer function at outset and at five years as defined by the Health Assessment Questionnaire (HAQ) score. This is not attributable to differences in disease duration in patients from the most deprived regions or compliance with treatment. Furthermore, these patients do not achieve over five years the initial functional level of those living in the most advantaged localities. C onclusion-PA patients from deprived areas have poorer function, which is associated with greater need-medical, social, and paramedical. Stra tegies and resources for healthcare need to be adjusted according to t his variation.