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Utility of the Brief Illness Perception Questionnaire to Monitor Patient Beliefs in Systemic Vasculitis

Author

Rheumatol. 2020 Apr 1;jrheum.190828. doi: 10.3899/jrheum.190828. Online ahead of print.

Mollie N Schwartz 1, Casey A Rimland 1, Kaitlin A Quinn 1, Marcela Ferrada 1, K Bates Gribbons 1, Joel S Rosenblum 1, Wendy Goodspeed 1, Elaine Novakovich 1, Peter C Grayson 1

Author Information

  • 1From the Systemic Autoimmunity Branch, National Institutes of Health, NIAMS, Bethesda, MD, USA; University of North Carolina at Chapel Hill School of Medicine, Medical Scientist Training Program, Chapel Hill, NC, USA; Division of Rheumatology, MedStar Georgetown University Hospital, Washington, District of Columbia, USA. Funding and Conflict of Interest Disclosure: This research was supported by the Division of Intramural Research of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. The authors declare no conflicts of interest. Corresponding Author: Peter C Grayson, MD National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, Bethesda, MD 10 Center Drive, 10N-311D Bethesda, Maryland 20892. Email: peter.grayson@nih.gov.

Abstract

Objective: To assess the validity and clinical utility of the Brief Illness Perception Questionnaire (BIPQ) to measure illness perceptions in multiple forms of vasculitis.

Methods: Patients with giant cell arteritis (GCA), Takayasu's arteritis (TAK), ANCA-associated vasculitis (AAV) and relapsing polychondritis (RP) were recruited into a prospective, observational cohort. Patients independently completed the BIPQ, Multidimensional Fatigue Inventory (MFI), SF-36 Health Survey (SF-36) and a Patient Global Assessment (PtGA) at successive study visits. Physicians concurrently completed a Physician Global Assessment (PhGA) form. Illness perceptions, as assessed by the BIPQ, were compared to responses from the full-length Revised Illness Perception Questionnaire (IPQ-R) and to other clinical outcome measures.

Results: 196 patients (GCA=47, TAK=47, RP=56, AAV=46) were evaluated over 454 visits. Illness perception scores in each domain were comparable between the BIPQ and IPQ-R (3.28 vs 3.47, p=0.22). Illness perceptions differed by type of vasculitis, with the highest perceived psychological burden of disease in RP. The BIPQ was significantly associated with all other patient-reported outcome measures (ρ=0.50-0.70, p<0.0001) but did not correlate with PhGA (ρ=0.13, p=0.13). A change in the BIPQ composite score of ≥7 over successive visits was associated with concomitant change in the PtGA. Change in the MFI and BIPQ scores significantly correlated over time (ρ= 0.38, p=0.0008).

Conclusion: The BIPQ is an accurate and valid assessment tool to measure and monitor illness perceptions in patients with vasculitis. Use of the BIPQ as an outcome measure in clinical trials may provide complimentary information to physician-based assessments.