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Title: Epidemiology of ankylosing spondylitis utilizing the Scotland and Ireland Registry for Ankylosing Spondylitis
Author: Dean, Linda E.
ISNI:       0000 0004 5360 5521
Awarding Body: University of Aberdeen
Current Institution: University of Aberdeen
Date of Award: 2015
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Background: For effective provision of healthcare, knowledge of disease epidemiology is of paramount importance. Within Ankylosing Spondylitis (AS), however, several areas are poorly understood, including information regarding disease prevalence and natural history, and the quality of life (QoL) of patients. This thesis aimed to address these areas, specifically to: a) determine the prevalence of AS, b) identify determinants of poor QoL, and c) describe the natural history of the disease. Methods: The Scotland and Ireland Registry for Ankylosing Spondylitis (SIRAS) was used to fulfill these aims and collects clinical and patient-reported information on all AS patients seen within Scottish secondary care. AS prevalence was calculated as the number of patients, per 10,000 adults, while QoL was described using the Ankylosing Spondylitis Quality of Life (ASQoL) questionnaire and factors associated with poor QoL assessed using Poisson regression. To assess the natural history of AS, the mean scores of commonly collected disease measures (including disease activity) were plotted yearly, from diagnosis. Results: The prevalence of AS was calculated to be 4.7 per 10,000. Poor QoL was associated with being retired/unemployed due to ill health, poor physical function, high disease activity, pain, fatigue, poor spinal mobility and being prescribed a biologic therapy. Regarding the natural history of AS; of the clinical measures studied, all remained relatively stable over time at the group level; however differences were demonstrated, when stratifying by gender, initial disease activity and by biologic use. Discussion/Conclusions: This study has added to the knowledge of disease in three main ways: accurate prevalence estimates aid the distribution of healthcare, the factors associated with reporting poor QoL may provide novel targets for future intervention and the reported consistency in the natural history of the disease may be used to reassure patients who present with low disease activity while initiating aggressive therapy for those with initial high activity.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Ankylosing spondylitis