The impact of socioeconomic factors on disease activity in rheumatoid arthritis (RA) varies by academic or safety net hospital setting, according to a study. published online Oct. 18 inches ACR Open Rheumatology.

Joseph Kim, MD, from the University of Texas Southwestern Medical Center in Dallas, and colleagues analyzed the impact of the Area Deprivation Index (ADI) on disease activity and cardiovascular comorbidity in RA. The analysis included data from 542 patients seen at an academic practice and 496 treated at a safety net hospital.

The researchers found that in the academic cohort, compared with those with low ADI scores (<3, less deprivation), those with high ADI scores (>8, more deprivation) had higher RA disease activity scores, as measured by the Routine Assessment of Patient Index and the Clinical Disease Activity Index, and more functional impairment, as measured by the Multidimensional Health Assessment Questionnaire, lower MyChart use, and different smoking history. The only significant difference seen in the safety net cohort was for smoking status.

“The absence of differences in RA disease activity and functional impairment in patients suggests that the ADI may not be as effective at predicting RA disease activity specifically in a safety net health care context,” the authors write. “Identifying the discrepancies between the two systems may elucidate areas of improvement for patient care.”

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