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Poster Session C

Rheumatoid arthritis (RA)

Session: (2095–2140) RA – Diagnosis, Manifestations, and Outcomes Poster III

2107: Social Determinants of Health and Clinical Outcomes in Rheumatoid Arthritis: A Single Center Study

Tuesday, November 14, 2023
9:00 AM - 11:00 AM PT
Location: Poster Hall
On Demand In Person

    Abstract Poster Presenter(s)

  • NW

    Nicholas Wiemer, DO

    Allegheny Health Network
    Pittsburgh

    Disclosure information not submitted.

Nicholas Wiemer1, Yue Yin2 and Tarun Sharma1, 1Allegheny Health Network, Pittsburgh, PA, 2Allegheny Health Network Singer Research Institute, Pittsburgh, PA

Background/Purpose: Rheumatoid arthritis (RA) is a chronic and potentially debilitating disease.Social determinants, including smoking and depression, have been shown to be linked to worse clinical outcomes in RA.In this study, we aim to determine the prevalence of eleven social determinants of health (SDOH) in the RA cohort at our health system.

Methods: A retrospective review of patients seen as part of the RA Care Pathway, a well-defined cohort of adult patients with RA at AHN Rheumatology, was performed.Demographics, serologies, medications, and SDOH metrics were captured and validated via chart review. Patients were included if they had a RA Clinical Disease Activity Index (CDAI) and at least 3 social determinants completed within 6 months of each other. Patients were then examined in two groups, CDAI ≥10 (moderate-severe RA) and CDAI < 10 (remission and low disease activity) to assess any differential impact of SDOH.

Results: A total of 137 patients were reviewed, of which 50 met inclusion criteria. Average age was 65.5 years, 74% were female, and 66% were Caucasian. Mean CDAI was 9.64 with 36% patients in the moderate-severe CDAI group. Several SDOH metrics were unfavorably distributed in the CDAI ≥10 compared to < 10 group, including smoking (55.56% vs 31.25%), housing instability (11.11% vs 0%), depression (16.67% vs 6.25% with mean PHQ9 scores 18 vs 0.88, respectively), and low health literacy (11.11% vs 46.88%).Smoking patients were more likely to have high disease activity (OR 2.25, 95% CI [1.03, 4.89], p=0.04).

Conclusion: Our data reveals that RA patients with moderate-high disease activity are more likely to have high risk social determinants of health including high likelihood of smoking, housing instability, and depression. A team-based care approach has been implemented at AHN Rheumatology. Our next steps are to better capture SDOH and determine the impact of SDOH interventions on clinical outcomes in RA.


SDoH: social determinants of health, CDAI: clinical disease activity index, PHQ: patient health questionnaire


PHQ: patient health questionnaire


N. Wiemer: None; Y. Yin: None; T. Sharma: None.