Effect of education on disease activity and functional status in rheumatoid arthritis patients

Aim of the work: To study the effect of education on rheumatoid disease in a cohort of Egyptian patients. Patients and methods: This study included 1022 consecutive rheumatoid arthritis (RA) patients recruited from several rheumatology clinics of public and private sectors from Cairo, Kafr Elsheik and Fayoum governorates. Their mean age was 45.1 +/- 12.4 years and mean disease duration was 85.9 +/- 73 months. Patients were divided into groups according to their educational level (university degree/high school/illiterate) and were compared regarding their disease activity score (DAS28) and modified health assessment questionnaire (mHAQ) as a measure of the functional status. Results: The mean age of patients was 45.1 +/- 12.4 years, they were 854 females and 168 males and disease duration of 85.9 +/- 73 months. 106 (10.4%) were smokers and 333 (32.6%) were employed. 342 (33.5%) were illiterate, 455 (44.5%) were non-university-educated and 225 (22%) university educated. Educated patients showed significant lower disease activity (p = 0.001), swollen joint count (p = 0.044), tender joint count (p = 0.001), doctors global assessment (p = 0.001), erythrocyte sedimentation rate (p = 0.003) and visual analogue scale (p = 0.001). Educated patients had significantly received more biologic therapy (p = 0.001) and attended regular follow-up (p = 0.001). They showed better functional status with significantly lower MHAQ and had significant higher percentage of employment (p = 0.001). Rheumatoid patients with a university degree had significantly lower diseases activity and better functional indices compared to those without. Further regression analysis showed that university education is a predictor for low disease activity. Conclusion: Rheumatoid disease is influenced by education among Egyptians. Higher educated patients had lower disease activity and better functional outcome, and university education predicts low disease activity among Egyptian RA patients. (C) 2020 Egyptian Society of Rheumatic Diseases. Publishing services provided by Elsevier B.V.