Exploring factors influencing patient activation in Saudi rheumatoid arthritis patients: A Nationwide Cross-Sectional Survey-Results from the COPARA study

Objectives: To evaluate patient activation in rheumatoid arthritis (RA) patients using patient activation measure 13 (PAM-13) on a national level in Saudi Arabia. Method: A national survey was administered across multiple centers in Saudi Arabia. Patient activation was assessed using the PAM-13. The Compliance Questionnaire for Rheumatology (CQR) and the RA Impact of Disease (RAID) tool were also administered. The data from the survey were analyzed, and the results were stratified based on activation level. All factors affecting patient activation were explored and reported. Results: A total of 1241 participants were included. Most of the patients were females (85%), the mean age was 47 (+/- 14), and most patients lived in the central region (47%). The mean (+/- standard deviation) patient activation score was 578.7 (+/- 13.0). Patient activation was affected by multiple factors: demographic characteristics, such as education, with a beta value of 1.11 (95% confidence interval [CI] 0.64.1.58, p <.001). Higher CQR scores were associated with higher activation levels, with a beta value of 2.61 (95% CI 0.80.4.44, p =.005), and higher RAID scores were associated with lower activation levels, with a beta value of 3.13 (95% CI 1.36.4.91, p =.001). Conclusions: Patient activation was affected by several demographic characteristics and the impact of RA. A higher activation may improve compliance. Future longitudinal studies are required to confirm these findings and should explore the underlying mechanism of these effects.