The association of polymyalgia rheumatica with socioeconomic status in primary care: a cross-sectional observational study.
Hayward RA, Rathod T, Muller S, Hider SL, Roddy E, Mallen C.
OBJECTIVES: Polymyalgia rheumatica (PMR) is an inflammatory musculoskeletal condition, predominantly diagnosed and managed in the community. Socioeconomic status (SES) is known to be associated with many inflammatory rheumatological conditions, but has not been investigated in relation to PMR. This study aims to investigate the association between PMR and SES at both the area and the individual level. METHODS: Patients over 50 years registered with eight general practices in North Staffordshire were sent a questionnaire requesting details of their general health, socioeconomic status (SES) and lifestyle. Individual SES was measured using occupation, educational level and perceived adequacy of income. Area level SES was measured using the Index of Multiple Deprivation (IMD), derived from respondents' postcodes. Electronic primary care medical records were searched for Read code diagnoses of PMR two years before and after the survey. RESULTS: Of the 13,831 respondents, 141 had a recorded PMR diagnosis in their electronic medical records, a prevalence of 10 per 1000 patients. No association between PMR and SES was seen at either the individual or area levels. CONCLUSIONS: No association was found between PMR and SES, at either the area or the individual level. Unlike several of the inflammatory arthritides which are commoner in the more deprived areas, PMR shows no such association. In part this may be due to PMR affecting an older population. Whilst socioeconomic factors are important for clinicians and researchers to consider, in patients with PMR further epidemiological work is needed to fully characterise this disabling disorder. © 2013 American College of Rheumatology