ORCID Profile
0000-0001-6558-7189
Current Organisation
University of Aberdeen
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Publisher: Springer Science and Business Media LLC
Date: 31-05-2022
DOI: 10.1007/S00198-022-06435-6
Abstract: We describe the collection of cohorts together with the analysis plan for an update of the fracture risk prediction tool FRAX with respect to current and novel risk factors. The resource comprises 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. The availability of the fracture risk assessment tool FRAX® has substantially enhanced the targeting of treatment to those at high risk of fracture with FRAX now incorporated into more than 100 clinical osteoporosis guidelines worldwide. The aim of this study is to determine whether the current algorithms can be further optimised with respect to current and novel risk factors. A computerised literature search was performed in PubMed from inception until May 17, 2019, to identify eligible cohorts for updating the FRAX coefficients. Additionally, we searched the abstracts of conference proceedings of the American Society for Bone and Mineral Research, European Calcified Tissue Society and World Congress of Osteoporosis. Prospective cohort studies with data on baseline clinical risk factors and incident fractures were eligible. Of the 836 records retrieved, 53 were selected for full-text assessment after screening on title and abstract. Twelve cohorts were deemed eligible and of these, 4 novel cohorts were identified. These cohorts, together with 60 previously identified cohorts, will provide the resource for constructing an updated version of FRAX comprising 2,138,428 participants with a follow-up of approximately 20 million person-years and 116,117 documented incident major osteoporotic fractures. For each known and candidate risk factor, multivariate hazard functions for hip fracture, major osteoporotic fracture and death will be tested using extended Poisson regression. Sex- and/or ethnicity-specific differences in the weights of the risk factors will be investigated. After meta-analyses of the cohort-specific beta coefficients for each risk factor, models comprising 10-year probability of hip and major osteoporotic fracture, with or without femoral neck bone mineral density, will be computed. These assembled cohorts and described models will provide the framework for an updated FRAX tool enabling enhanced assessment of fracture risk (PROSPERO (CRD42021227266)).
Publisher: Wiley
Date: 29-06-2022
DOI: 10.1002/ACR.24595
Abstract: To describe the driving difficulties experienced by in iduals with axial spondyloarthritis (SpA), and to characterize associated clinical and sociodemographic features and impact on work. The Scotland Registry for Ankylosing Spondylitis (SIRAS) is a cohort study of patients with a clinical diagnosis of axial SpA. Baseline information was collected on clinical and patient‐reported measures and work participation measures (using the Work Productivity and Activity Impairment Questionnaire: Specific Health Problem [WPAI:SHP]). Patient‐rated difficulties with 9 driving tasks were used in a factor analysis, and relationships between driving difficulty and work participation were investigated. In total, 718 patients provided data for analysis, of which 642 (89%) had some difficulty with at least 1 driving task, and 72 (10%) had some difficulty with all 9 tasks. Three domains of driving difficulty were identified: dynamic driving scenarios, crossing traffic, and the physical act of driving. Chronic widespread pain, knee and back pain, fatigue, high disease activity, and anxiety/depression were significantly associated with reporting driving difficulties across all 3 domains, particularly the physical act of driving. After adjusting for sociodemographic, disease activity, physical and mental health, driving difficulties in each domain were associated with a 2–3 times increased likelihood of restricted work productivity and with an increased risk of sickness absence in the past 7 days. Driving difficulties are common in in iduals with axial SpA and impact on work, even after adjusting for clinical status. Improving understanding and awareness of driving disability will help direct advice and resources to enable in iduals to remain independent and economically active.
Publisher: Springer Science and Business Media LLC
Date: 11-08-2023
Publisher: BMJ
Date: 10-06-2020
DOI: 10.1136/ANNRHEUMDIS-2020-216988
Abstract: To examine differences in clinical and patient-reported outcomes, including work, in in iduals with axial spondyloarthritis (axSpA) living in rural and urban settings. Using a sequential, explanatory mixed-method design, data from the British Society for Rheumatology Biologics Register for Ankylosing Spondylitis were used to (1) characterise participants with axSpA living in rural and urban areas and (b) assess any differences in outcome after commencement of biologic therapy (phase 1). Semistructured interviews (phase 2) further explored the results from phase 1. Patients with axSpA living in rural areas were older and more likely to work in a physical job. Among patients prescribed biologics, there were no differences in response to biologics, but after adjustment for age, sex and local area deprivation rural dwellers reported more presenteeism and overall work impairment. Work effects could be explained by accounting for in idual differences in disease activity, fatigue, physical function and job type. Interviews highlighted the complex relationship between clinical factors, contextual factors (work environment, job demands) and work disability. The ability to work and flexibility in terms of what, when and how tasks are undertaken were important. Support from employers was variable and healthcare professionals were often perceived as unsupportive. Patients with axSpA living in rural areas report a greater impact of their disease on work productivity. New measures are needed to capture important contextual factors and comprehensively determine the impact of long-term conditions on work. Future European League Against Rheumatism axSpA recommendations should include support to work as a target to optimise quality of life in patients with axSpA.
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-057919
Abstract: To understand what we can learn from the impact of the COVID-19 pandemic and lockdown about what enables work participation for people with inflammatory arthritis and chronic pain conditions. Qualitative interviews embedded within an observational questionnaire study of in iduals with musculoskeletal (MSK) conditions. UK primary care (general practices), and secondary care-based rheumatology services. In iduals with axial spondyloarthritis, psoriatic arthritis and MSK pain from three established cohorts completed an online aper-based questionnaire (July–December 2020). A subset of respondents were selected for semistructured interviews. The survey quantified the effects of lockdown on work circumstances. Qualitative interviews explored the impacts of these changes and the advantages and disadvantages of changes in work circumstances. 491 people (52% female, median age 49 years) who were employed at the time of lockdown responded to the questionnaire. The qualitative analysis included 157 free-text comments on work from the questionnaire and data collected within 18 interviews. Participants reported impacts on mental and physical health, and significant financial anxieties. The impact of work changes varied depending on in idual and home circumstances. Some felt forced to ignore advice to shield and continue working. The flexibility offered by home working and changes in commuting enabled greater physical activity for some, while others missed the exercise normally undertaken as part of their commute. Others reported a constant need to be ‘present’ online, which heightened anxiety and worsened MSK symptoms. Lockdown showed that flexible working arrangements, which consider the positive and negative aspects of commuting, posture, movement, and work environment matter for work participation, and can have wider benefits in terms of health and well-being for those with long-term MSK conditions. Incorporating these into new models of work will help make the workplace more equitable and inclusive for people with long-term MSK conditions.
Publisher: Royal College of Physicians
Date: 05-2021
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Rosemary Hollick.