Factors influencing Raynaud’s condition score diary outcomes in systemic sclerosis.

John D Pauling, Elizabeth Reilly, Theresa Smith, Tracy M Frech

Research output: Contribution to journalArticle

Abstract

Objectives: Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors e.g. season and personal factors e.g. coping strategies and ill-health perceptions. We explored the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity.

Methods: SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud’s Condition Score (RCS)-diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophisation Scale, Scleroderma Health Assessment Questionnaire (SHAQ) and both patient/physician visual analogue scale (VAS) assessments for RP, digital ulcer disease and global disease. Environmental temperature data was obtained at each site. A second RCS-diary was completed 6-months after enrolment.

Results: We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS-diary parameters and both catastrophisation and coping strategies. There were significant associations between RCS-diary outcomes and both environmental temperature and season of enrolment. Age, disease duration, sex, disease subtype, smoking and vasodilator use were not associated with RCS-diary outcomes. The best fitting multivariate model identified the patient RP VAS, the SHAQ pain VAS and the SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS score.

Conclusions: Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophisation and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioural interventions enhancing coping strategies may reduce the burden of SSc-RP.
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalThe Journal of Rheumatology
Volume46
Issue number9
Early online date1 Mar 2019
DOIs
Publication statusPublished - 1 Sep 2019

Cite this

Factors influencing Raynaud’s condition score diary outcomes in systemic sclerosis. / Pauling, John D; Reilly, Elizabeth; Smith, Theresa; Frech, Tracy M.

In: The Journal of Rheumatology, Vol. 46, No. 9, 01.09.2019, p. 1-10.

Research output: Contribution to journalArticle

@article{5a6d0aa9e3dd4e8f9ceac108bfc6d0fc,
title = "Factors influencing Raynaud’s condition score diary outcomes in systemic sclerosis.",
abstract = "Objectives: Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors e.g. season and personal factors e.g. coping strategies and ill-health perceptions. We explored the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity.Methods: SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud’s Condition Score (RCS)-diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophisation Scale, Scleroderma Health Assessment Questionnaire (SHAQ) and both patient/physician visual analogue scale (VAS) assessments for RP, digital ulcer disease and global disease. Environmental temperature data was obtained at each site. A second RCS-diary was completed 6-months after enrolment. Results: We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS-diary parameters and both catastrophisation and coping strategies. There were significant associations between RCS-diary outcomes and both environmental temperature and season of enrolment. Age, disease duration, sex, disease subtype, smoking and vasodilator use were not associated with RCS-diary outcomes. The best fitting multivariate model identified the patient RP VAS, the SHAQ pain VAS and the SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS score.Conclusions: Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophisation and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioural interventions enhancing coping strategies may reduce the burden of SSc-RP.",
author = "Pauling, {John D} and Elizabeth Reilly and Theresa Smith and Frech, {Tracy M}",
year = "2019",
month = "9",
day = "1",
doi = "10.3899/jrheum.180818",
language = "English",
volume = "46",
pages = "1--10",
journal = "The Journal of Rheumatology",
issn = "0315-162X",
publisher = "Journal of Rheumatology",
number = "9",

}

TY - JOUR

T1 - Factors influencing Raynaud’s condition score diary outcomes in systemic sclerosis.

AU - Pauling, John D

AU - Reilly, Elizabeth

AU - Smith, Theresa

AU - Frech, Tracy M

PY - 2019/9/1

Y1 - 2019/9/1

N2 - Objectives: Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors e.g. season and personal factors e.g. coping strategies and ill-health perceptions. We explored the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity.Methods: SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud’s Condition Score (RCS)-diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophisation Scale, Scleroderma Health Assessment Questionnaire (SHAQ) and both patient/physician visual analogue scale (VAS) assessments for RP, digital ulcer disease and global disease. Environmental temperature data was obtained at each site. A second RCS-diary was completed 6-months after enrolment. Results: We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS-diary parameters and both catastrophisation and coping strategies. There were significant associations between RCS-diary outcomes and both environmental temperature and season of enrolment. Age, disease duration, sex, disease subtype, smoking and vasodilator use were not associated with RCS-diary outcomes. The best fitting multivariate model identified the patient RP VAS, the SHAQ pain VAS and the SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS score.Conclusions: Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophisation and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioural interventions enhancing coping strategies may reduce the burden of SSc-RP.

AB - Objectives: Raynaud’s phenomenon (RP) in systemic sclerosis (SSc) could be influenced by clinical phenotype, environmental factors e.g. season and personal factors e.g. coping strategies and ill-health perceptions. We explored the relative influence of a range of putative factors affecting patient-reported assessment of SSc-RP severity.Methods: SSc patients were enrolled at UK and US sites. Participants completed the 2-week Raynaud’s Condition Score (RCS)-diary alongside collection of patient demographics, clinical phenotype, the Coping Strategies Questionnaire, Pain Catastrophisation Scale, Scleroderma Health Assessment Questionnaire (SHAQ) and both patient/physician visual analogue scale (VAS) assessments for RP, digital ulcer disease and global disease. Environmental temperature data was obtained at each site. A second RCS-diary was completed 6-months after enrolment. Results: We enrolled 107 patients (baseline questionnaires returned by 94). There were significant associations between RCS-diary parameters and both catastrophisation and coping strategies. There were significant associations between RCS-diary outcomes and both environmental temperature and season of enrolment. Age, disease duration, sex, disease subtype, smoking and vasodilator use were not associated with RCS-diary outcomes. The best fitting multivariate model identified the patient RP VAS, the SHAQ pain VAS and the SHAQ gastrointestinal VAS subscales as the strongest independent predictors of the RCS score.Conclusions: Patient-reported assessment of SSc-RP severity is associated with a number of factors including pain, catastrophisation and coping strategies. The effects of seasonal variation in environmental temperature on SSc-RP burden has implications for clinical trial design. Treatments targeting SSc-RP pain and the development of behavioural interventions enhancing coping strategies may reduce the burden of SSc-RP.

U2 - 10.3899/jrheum.180818

DO - 10.3899/jrheum.180818

M3 - Article

VL - 46

SP - 1

EP - 10

JO - The Journal of Rheumatology

JF - The Journal of Rheumatology

SN - 0315-162X

IS - 9

ER -