title: Prevalence of rheumatic and musculoskeletal diseases and their impact on health-related quality of life, physical function and mental health in Portugal: results from EpiReumaPt- a national health survey.
abstract: OBJECTIVE
  To estimate the national prevalence of rheumatic and musculoskeletal diseases (RMDs) in the adult Portuguese population and to determine their impact on health-related quality of life (HRQoL), physical function, anxiety and depression.
  
  
  METHODS
  EpiReumaPt is a national health survey with a three-stage approach. First, 10 661 adult participants were randomly selected. Trained interviewers undertook structured face-to-face questionnaires that included screening for RMDs and assessments of health-related quality of life, physical function, anxiety and depression. Second, positive screenings for ≥1 RMD plus 20% negative screenings were invited to be evaluated by a rheumatologist. Finally, three rheumatologists revised all the information and confirmed the diagnoses according to validated criteria. Estimates were computed as weighted proportions, taking the sampling design into account.
  
  
  RESULTS
  The disease-specific prevalence rates (and 95% CIs) of RMDs in the adult Portuguese population were: low back pain, 26.4% (23.3% to 29.5%); periarticular disease, 15.8% (13.5% to 18.0%); knee osteoarthritis (OA), 12.4% (11.0% to 13.8%); osteoporosis, 10.2% (9.0% to 11.3%); hand OA, 8.7% (7.5% to 9.9%); hip OA, 2.9% (2.3% to 3.6%); fibromyalgia, 1.7% (1.1% to 2.1%); spondyloarthritis, 1.6% (1.2% to 2.1%); gout, 1.3% (1.0% to 1.6%); rheumatoid arthritis, 0.7% (0.5% to 0.9%); systemic lupus erythaematosus, 0.1% (0.1% to 0.2%) and polymyalgia rheumatica, 0.1% (0.0% to 0.2%). After multivariable adjustment, participants with RMDs had significantly lower EQ5D scores (β=-0.09; p<0.001) and higher HAQ scores (β=0.13; p<0.001) than participants without RMDs. RMDs were also significantly associated with the presence of anxiety symptoms (OR=3.5; p=0.006).
  
  
  CONCLUSIONS
  RMDs are highly prevalent in Portugal and are associated not only with significant physical function and mental health impairment but also with poor HRQoL, leading to more health resource consumption. The EpiReumaPt study emphasises the burden of RMDs in Portugal and the need to increase RMD awareness, being a strong argument to encourage policymakers to increase the amount of resources allocated to the treatment of rheumatic patients.
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal; EpiDoc Unit-Unidade de Epidemiologia em Doenças Crónicas (CEDOC, NMS/UNL), Lisboa, Portugal; Programa Nacional Contra as Doenças Reumáticas (2006-2014), Direcção Geral da Saúde, Lisboa, Portugal.
authors: Jaime C
authors: JC
authors: Branco
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; EpiDoc Unit-Unidade de Epidemiologia em Doenças Crónicas (CEDOC, NMS/UNL), Lisboa, Portugal; Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors: Ana M
authors: AM
authors: Rodrigues
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal; EpiDoc Unit-Unidade de Epidemiologia em Doenças Crónicas (CEDOC, NMS/UNL), Lisboa, Portugal.
authors: Nélia
authors: N
authors: Gouveia
authors: Sociedade Portuguesa de Reumatologia , Lisboa , Portugal.
authors: Mónica
authors: M
authors: Eusébio
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal; Leiden University Medical Center, Leiden, The Netherlands.
authors: Sofia
authors: S
authors: Ramiro
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Clínica Universitária de Reumatologia, Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal; Centre for Rheumatology Research & MRC Centre for Neuromuscular Diseases, University College London, London, UK.
authors: Pedro M
authors: PM
authors: Machado
authors: Centro de Estudos e Sondagens de Opinião da Universidade Católica Portuguesa (CESOP-CATÓLICA) , Lisboa , Portugal.
authors: Leonor Pereira
authors: LP
authors: da Costa
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal; Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Lisboa, Portugal.
authors: Ana Filipa
authors: AF
authors: Mourão
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisboa, Portugal.
authors: Inês
authors: I
authors: Silva
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors: Pedro
authors: P
authors: Laires
authors: Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC) da NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal; Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Lisboa, Portugal.
authors: Alexandre
authors: A
authors: Sepriano
authors: Serviço de Reumatologia do Hospital Egas Moniz-Centro Hospitalar Lisboa Ocidental (CHLO-EPE), Lisboa, Portugal; Instituto de Microbiologia, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; Unidade Curricular Especialidades Médico-Cirúrgicas I, NOVA Medical School, Universidade Nova de Lisboa (NMS/UNL), Lisboa, Portugal.
authors: Filipe
authors: F
authors: Araújo
authors: Instituto Piaget, Lisboa, Portugal; Unidade de Epidemiologia do Instituto de Medicina Preventiva e Saúde Pública da Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors: Sónia
authors: S
authors: Gonçalves
authors: NOVA IMS, Universidade Nova de Lisboa , Lisboa , Portugal.
authors: Pedro S
authors: PS
authors: Coelho
authors: Hospital Garcia de Orta, Almada, Portugal; Hospital Garcia de Orta, EPE, Almada, Portugal; APOROS-Associação Nacional contra a Osteoporose, Lisboa, Portugal.
authors: Viviana
authors: V
authors: Tavares
authors: Sociedade Portuguesa de Reumatologia , Lisboa , Portugal.
authors: Jorge
authors: J
authors: Cerol
authors: NOVA IMS, Universidade Nova de Lisboa , Lisboa , Portugal.
authors: Jorge M
authors: JM
authors: Mendes
authors: Instituto de Salud Musculoesquelética , Madrid , Spain.
authors: Loreto
authors: L
authors: Carmona
authors: EpiReumaPt Study Group-Sociedade Portuguesa de Reumatologia, Lisboa, Portugal; EpiDoc Unit-Unidade de Epidemiologia em Doenças Crónicas (CEDOC, NMS/UNL), Lisboa, Portugal; Unidade de Investigação em Reumatologia, Instituto de Medicina Molecular, Lisboa, Portugal; Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal; Serviço de Reumatologia do Hospital de Santa Maria, Centro Hospitalar Lisboa Norte (CHLN-EPE), Lisboa, Portugal.
authors: Helena
authors: 0000-0003-1894-4870
authors: H
authors: Canhão
keywords: Epidemiology; Fibromyalgis/Pain Syndromes; Low Back Pain; Osteoarthritis; Spondyloarthritis