Rheumatoid arthritis and sexuality: A patient survey in France

BMC Musculoskeletal Disorders

Bernard Combe⁶  Yves Maugars¹  Aleth Perdriger⁷  David-Romain Bertholon²  Anne-Sophie Woronoff⁴  Sylvain Mimoun⁵  Brigitte Texier-Richard²  Gisela Kobelt³ 

[1] Centre Hospitalier Universitaire Nantes, Nantes, France;EmPatient, Paris, France;European Health Economics, 492 chemin des Laurens, 06530 Spéracèdes, Mulhouse, France;ANDAR, Clermont l’Hérault, France;Unité d’étude de la sexualité humaine, Hôpital Robert Debré, Paris, France;Hôpital Lapeyronie, Centre Hospitalier Universitaire Montpellier, Montpellier, France;Centre Hospitalier Universitaire Rennes, Rennes, France

关键词: Sexuality;    Quality of life;    Fatigue;    Rheumatoid arthritis;   

Others  :  1145860
DOI  :  10.1186/1471-2474-13-170

 received in 2012-02-06, accepted in 2012-08-24,  发布年份 2012

【 摘 要 】

Background

The objective of this study was to evaluate the impact of rheumatoid arthritis (RA) on patients’ sexuality and identify disease and other factors such as fatigue that most influence sexual relationships.

Methods

A specific pretested questionnaire was sent to all members of a French patient association (ANDAR). Questions related to demographics, disease status, quality of life (utility, EQ-5D), pain, psychological status (mood), fatigue and emotional and sexual relationships. To isolate the impact of RA, an attempt was made to include a matched sample from the general population.

Results

The analysis included 1271 patients, but only 70 controls agreed to participate and comparisons should therefore be considered with caution. The two groups were similar in terms of age, gender distribution, living conditions and diseases other than RA. However, patients scored worse for global health, mood, fatigue, had a lower utility (0.55 versus 0.65). Controls were more active sexually (69% versus 63%), in particular women (71% versus 60%). Age, gender, living alone, physical function and mood were significant predictors for being sexually active for patients; for controls, age and overall quality of life (utility) were significant predictors.

Conclusions

While it is known that RA has a negative impact on patients’ sexuality, there have been few attempts to quantify the problem. Our study highlights the negative impact of RA on patients’ sexuality, and triggers the question how to include this aspect into care.

【 授权许可】

   
2012 Kobelt et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Thompson M, Leighton-Read J, Hutchings C, Paterson M, Jr EH: The Cost Effectiveness of Auranofin. Results of a Randomized Clinical Trial. Journal of Rheumatology 1988, 15:35-42.
• [2]Kalyoncu U, Dougados M, Daures JP, Gossec L: Reporting of patient-reported outcomes in recent trials in rheumatoid arthritis: a systematic literature review. Ann Rheum Dis 2009, 68:183-90.
• [3]Kobelt G, Eberhardt K, Jönsson L, Jönsson B: Economic consequences of the progression of rheumatoid arthritis in Sweden. Arthritis & Rheumatism 1999, 42:347-56.
• [4]Kobelt G, Andlin-Sobocki P, Maksymowych WP: Costs and quality of life of patients with ankylosing spondylitis in Canada. J Rheumatol 2006, 33:289-95.
• [5]Gulfe A, Kristensen LE, Saxne T, Jacobsson LT, Petersson IF, Geborek P: Rapid and sustained health utility gain in anti-TNF treated inflammatory arthritis. Observational data during seven years in southern Sweden, Ann Rheum Dis; 2009.
• [6]Pouchot J, Kherani RB, Brant R, et al.: Determination of the minimal clinically important difference for seven fatigue measures in rheumatoid arthritis. J Clin Epidemiol 2008, 61:705-13.
• [7]Mayoux-Benhamou MA: Fatigue and rheumatoid arthritis. Ann Readapt Med Phys 2006, 49(301–4):85-8.
• [8]Fifield J, McQuinnan J, Tennan H, et al.: History of affective disorder and temporal trajectory of fatigue in rheumatoid arthritis. Ann Behavioral Med 2001, 23:34-41.
• [9]Pollard LC, Choy EH, Gonzalez J, Khoshaba B, Scott DL: Fatigue in rheumatoid arthritis reflects pain, not disease activity. Rheumatology (Oxford) 2006, 45:885-9.
• [10]Hewlett S, Hehir M, Kirwan JR: Measuring fatigue in rheumatoid arthritis: a systematic review of scales in use. Arthritis Rheum 2007, 57:429-39.
• [11]Wolfe F, Michaud K: Predicting depression in rheumatoid arthritis: the signal importance of pain extent and fatigue, and comorbidity. Arthritis Rheum 2009, 61:667-73.
• [12]Areskoug-Josefsson K, Oberg U: A literature review of the sexual health of women with rheumatoid arthritis. Musculoskeletal Care 2009, 7:219-26.
• [13]Tristano AG: The impact of rheumatic diseases on sexual function. Rheumatol Int 2009, 29:853-60.
• [14]Helland Y, Dagfinrud H, Kvien TK: Perceived influence of health status on sexual activity in RA patients: associations with demographic and disease-related variables. Scand J Rheumatol 2008, 37:194-9.
• [15]van Berlo WT, van de Wiel HB, Taal E, Rasker JJ, Weijmar Schultz WC, van Rijswijk MH: Sexual functioning of people with rheumatoid arthritis: a multicenter study. Clin Rheumatol 2007, 26:30-8.
• [16]Pouchot J, Le Parc JM, Queffelec L, Sichere P, Flinois A: Perceptions in 7700 patients with rheumatoid arthritis compared to their families and physicians. Joint Bone Spine 2007, 74:622-6.
• [17]Kobelt G, Woronoff AS, Richard B, Peeters P, Sany J: Disease status, costs and quality of life of patients with rheumatoid arthritis in France: the ECO-PR Study. Joint Bone Spine 2008, 75:408-15.
• [18]Fries J, Spitz P, Kraines R, Holman H: Measurement of patient outcome in arthritis. Arthritis Rheumatism 1980, 23:137-45.
• [19]EuroQol G: EuroQol - a new facility for the measurement of health-related quality of life. Health Policy 1990, 16:199-208.
• [20]Gardenas J: Echelles et outils d'évaluation en Médecine GénéraleLe Généraliste. 2002, 2187.
• [21]EUROSTAT: Niveau d'éducation dans l'Union Européenne. 2008. http://epp.eurostat.ec.europa.eu webcite
• [22]INSEE: Enseignement-Éducation - Part de la population diplômée de l'enseignement supérieur dans l'Union européenne. 2008. http://www.insee.fr webcite
• [23]INSEE: Revenus-Salaires - Nombre et taux de personnes vivant sous le seuil de pauvreté selon leur âge. 2008. http://www.insee.fr webcite
• [24]Kobelt G, Kasteng F: Access to innovative treatments in Rheumatoid Arthritis in Europe 2009. www.comparatorreports.se webcite
• [25]Perneger T, Combescure C, Courvoisier S: General population reference values for the French version of the EuroQol EQ-5D health utility instrument.V. Value in Health 2010, 13:631-5.
• [26]Perdriger A, Solano C, Gossec L: Pourquoi les rhumatologues devraient-ils s’intéresser à la sexualité des patients souffrant d’une polyarthrite rhumatoïde ? Revue du Rhumatisme 2010, 77:415-7.