Facebook key to identifying thousands with inflammatory back pain

June 10, 2016

London, United Kingdom, June 9, 2016: The results of a UK study presented today at the European League Against Rheumatism Annual Congress (EULAR 2016) showed that using Facebook to raise awareness about the symptoms of Inflammatory Back Pain (IBP) and the need to seek medical help early may reduce the delay in diagnosis and treatment. The findings suggest that Facebook advertising may be a more effective way of identifying IBP patients earlier than other approaches, including newspaper adverts.

In the management of IBP, early diagnosis is key to reduce the risk of severe functional disability and early retirement. Correct diagnosis depends largely on the pattern of clinical symptoms and signs in addition to magnetic resonance imaging. Early diagnosis has become all the more important because biological therapies such as TNF inhibitors are available that effectively suppress disease activity and improve functional ability in patients that have been refractory to conventional drug therapy.2

A previous UK study showed an average delay in diagnosis of more than eight years, with almost one-third of diagnosed patients not referred to a rheumatologist. This is partly due to a failure of individuals with IBP symptoms to present to their GP, and partly to a failure of GPs to recognise those patients with chronic back pain that have an inflammatory rather than a mechanical cause.

"Patients with inflammatory back pain (IBP) can wait years for a correct diagnosis. Early treatment is critical in achieving better outcomes for these patients. We applied a novel recruitment method using Facebook over five months to identify adults in the community with symptoms suggestive of IBP, comparing the outcome with other forms of recruitment, principally newspaper advertising," said Dr Arumugam Moorthy of the Department of Rheumatology, University Hospitals of Leicester NHS trust, UK. "Facebook advertising recruited a younger group of respondents and a higher proportion of them fulfilled the criteria for a diagnosis of IBP compared to the group of patients recruited by other methods," Dr Moorthy explained.

Back pain is one of the most common medical complaints; it has been estimated to affect as many as 17.3 million people in the UK. However, the majority of these cases are due to a mechanical rather than an inflammatory cause. Among those patients presenting to their doctor at least once with back pain, the minimum estimated prevalence of IBP is equivalent to around 700,000 people. Patients with IBP typically experience severe lower back pain worse at night, not helped by rest, which can significantly interfere with an individual's mental health, ability to work and quality of life.

Of the 585 participants in this study, just over three quarters were recruited through Facebook and under one quarter by other methods. The mean age of the Facebook group was typical of IBP at 41.5 years; the mean age of the non-Facebook group was higher at 59.4 years. Three quarters of the recruited patients were female. Online questionnaire-based surveys to assess the two groups of recruited patients for a diagnosis of IBP showed that, among those recruited by Facebook, 56% met the Calin criteria and ASAS criteria for IBP. In contrast, in the group recruited by non-Facebook methods, 39% met the Calin and ASAS criteria.

The majority of patients from each group reported consulting their GP, however, few patients from either group had been referred to a rheumatologist. Regarding further investigations, 45% of the Facebook group reported having an MRI scan and 45% an X-ray, whereas 50% of the non-Facebook group reported having an MRI scan and 59% said they had been for an X-ray.

"Although most (81%) of the chronic back pain patients we recruited through Facebook had consulted their GP, only 13% had actually been referred to a rheumatologist, confirming the need for additional GP education," Dr Moorthy concluded.

Abstract Number: OP0145
-end-
NOTES TO EDITORS:

For further information on this study, or to request an interview with the study lead, please do not hesitate to contact the EULAR congress

Press Office in the London Suite at ExCel London during EULAR 2016 or on: Email: eularpressoffice@cohnwolfe.com

Onsite tel: +44 (0) 7725 915 492 / +44 (0) 7786 171 476

Twitter: @EULAR_Press

Youtube: Eular Pressoffice

About EULAR

The European League Against Rheumatism (EULAR) is an umbrella organisation which represents scientific societies, health professional associations and organisations for people with Rheumatic Musculoskeletal Diseases (RMD) throughout Europe.

EULAR aims to promote, stimulate and support the research, prevention, and treatment of RMD and the rehabilitation of those it affects.

EULAR underlines the importance of combating rheumatic diseases not only by medical means, but also through a wider context of care for rheumatic patients and a thorough understanding of their social and other needs. EULAR is supported in this mission by its 45 scientific member societies, 36 PARE (People with Arthritis/Rheumatism in Europe) organisations, 22 HPR (Health Professionals in Rheumatology) associations and 23 corporate members.

The EULAR Annual European Congress of Rheumatology is the foremost international medical meeting announcing the latest research on rheumatic and musculoskeletal diseases. EULAR 2016 is expected to attract over 14,000 delegates from around 120 countries. Most if not all professions working in the vast field of RMD will be represented.

To find out more about the activities of EULAR, visit: http://www.eular.org

References

1. EULAR 2016; London: Abstract OP0145

2. Elyan M, Khan MA. Diagnosing ankylosing spondylitis. J Rheumatol Suppl. 2006; 78: 12-23.

3. Hamilton L, Gilbert A, Skerrett J, et al. Services for people with ankylosing spondylitis in the UK -- a survey of rheumatologists and patients. Rheumatology (Oxford). 2011; 50 (11): 1991-8

4. Maniadakis N, Gray A. The economic burden of back pain in the UK. Pain. 2000; 84(1): 95-103

5. Hamilton L, Macgregor A, Warmington V, et al. The prevalence of inflammatory back pain in a UK primary care population. Rheumatology (Oxford). 2014; 53(1): 161-4.

6. Calin A, Porta J, Fries JF, Schurman DJ. Clinical history as a screening test for ankylosing spondylitis. JAMA 1977; 237: 2613-4

7. Sieper, J. van der Heijde D, Landewé R, et al. New criteria for inflammatory back pain in patients with chronic back pain: a real patient exercise by experts from the Assessment of SpondyloArthritis International Society (ASAS). Ann. Rheum. Dis. 68, 784-788

European League Against Rheumatism

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