2.3%
Monthly Income (RM)
FROM THE EDITOR’S DESK Malay
30.4%
Chinese 43.2% Indian Other
Figure 2: DISTRIBUTION OF ETHNIC GROUPS
1001-3000 < 1000 0
35
% of Patients
30 25 20 15 10 5
Monthly Income (RM)
30.4%
Chinese 43.2% Indian Other
9.3
Unknown 2% >7000
4.1
5001-7000
5.8 32% 12.8
3001-5000 1001-3000 26% < 1000
24.1%
37.7
8% Unemployed
0
5 32%
10
15
30.3
20
25
30
35
40
% of patients 51.8% Due to Disease
nese
an
> 12 months 15.69 13.81GROUP FIGURE 3: MONTHLY INCOME
40 44.11 4.1
36.52
5.8
5001-7000 0 3001-5000
12.8
Professional
Non-Professional 37.7
1001-3000 2.3%
< 1000
her
6 to 12 months < 6 months
9.3
Unknown 20 >7000
0
5
30.3
10
15
20
25
30
35
40
Malay
30.4%
Patient Diagnosis Comparing professionals and non32% 43.2% Indian professionals, the professionals are diagnosed earlier, that 40 37.5 Other is less than 6 months from disease onset. However, even 26% 35 8% Unemployed 24.1% amongst the professionals, about 40% were diagnosed 30 more than a year from the onset of symptoms. 23.2 25 Chinese
% of Patients
> 12 months
32%
20 FIGURE 4: DURATION OF DISEASE BEFORE DIAGNOSIS COMPARING 51.8% 17.2 Due to Disease PROFESSIONALS AND NON-PROFESSIONALS
6 to 12 months
15
Full Time 120 10 Retired 5 N = 102 100 0.6 0 % of Patients
< 6 months
80 60
10.3 Part-time 4.3Home-maker
N = 898
Unemployed Due to Disease 6.9 Unemployed Due to Family Unemployed Others
49.67 to 50 51 to 60 61-70 12 to 20 21 to 30 31 to 40 41 40.2 Age of Group 15.69
13.81
40
> _ 71
> 12 months 6 to 12 months < 6 months
20
44.11
36.52
Professional
Non-Professional
0
Unemployed Due to Disease Unemployed Due to Family 37.5 Unemployed Others
30
Treatment of patients were started 25 A large proportion 23.2 on Disease (DMARDS) 20 Modifying Anti-Rheumatic Drugs 17.2 soon after15 the diagnosis was made. This is in accordance 10.3 with current treatment recommendations. Methotrexate 10 6.9 (MTX) being the anchor drug in the treatment of 4.3 5 0.6 Rheumatoid Arthritis was used in 86.6% of patients. 0 > This was followed (SSZ) at 69.5% _ 71 21 to sulphasalazine 30 31 to 40 41 to 50 51 to 60 61-70 12 to 20 by and hydroxychloroquine (HCQ) 34.6%. Many of the Age ofat Group patients were on combination therapies. Unknown
Conclusion 4.1 >7000
% of patients 2%
Home-maker
9.3
Thus far, several5.8interesting results have been obtained 5001-7000 from the registry. 12.8 3001-5000 37.7 1001-3000 • The data confirms that rheumatoid arthritis has a very 30.3 < 1000 significant socio-economic impact on society. Therefore, 15 20 25 to30reduce 35 40 0 policies need to5 be10implemented the financial % of patients burden to patients and to society as a whole. • There is also an urgent need to raise awareness among the general public regarding the early diagnosis of the 40 disease and primary care physicians37.5 need to refer patients early to 35 rheumatologists. 30 The NIAR data offers much potential for further 23.2 serve as an impetus for the research25and hopefully, this will 20 implementation of policies for the benefit17.2of patients and society at 15 large. % of Patients
lay
60
40.2
Part-time
40 Retired 35
Monthly Income (RM)
Monthly Income (RM)
% of Patients
80
Full Time
% of Patients
Income The majority of patients were from the lower socio-economic group. Nearly 90% were non-professionals 120 and two-thirds had a monthly income N = of 898 less than N = 102 RM3,000. Two-thirds also did not have any personal 100 medical insurance. 49.67
10.3
10
6.9 4.3
To find5 out 0.6 how to participate in the NIAR, please contact0 your nearest hospital with a rheumatologist. > _ 71 12 to 20 21 to 30 31 to 40 41 to 50 51 to 60 61-70 Age of Group
DECEMBER APRIL 2014 / JOINT EFFORTS
25
2% 51.8% Due to Disease
01-32_JE Final FA.indd 25
32%
0.6
0
FIGURE 5: WORK STATUS AND REASONS FOR UNEMPLOYMENT
Malay
5
40
N = 898
N = 102 Arthritis 100And Unemployment For the patient, pain and physical activity limitations may impact his or her daily 49.67 80 40.2 activities. One of the more interesting results but perhaps > 12 months 60 not surprising is the impact of RA on patients work status. 15.69 13.81 6 to 12 months Only 8% 40 of patients reported they were unemployed but months significantly, nearly 52% of those who were< 6unemployed 20 44.11 36.52 attributed this to their disease. A considerable number of patients 0(32% of patients) were home-makers. It would be Professional Non-Professional interesting to find out whether the decision to be a homemaker was influenced by their disease.
2.3%
5
3001-5000
The AFM is proud to be part of this groundbreaking Malaysian study and with contributions from the public and industry, we hope to continue to help fund this important initiative. 120
4.1
>7000 5001-7000
24.1%
% of Patients
Race The Malays being the largest ethnic group in Malaysia made up 43.2% of the patients in the registry. The Indians who are the smallest of the 3 major ethnic groups in Malaysia made up 30.4% followed by the Chinese at 24.1%. The other ethnic groups and foreigners comprised 2.3% of the patients. The Indians are over-represented since they constitute only 7.1% of the Malaysian population. This is perhaps due to a sampling bias; either because of the areas covered by the three hospitals or as more Indian patients seek treatment at government hospitals. The underrepresentation of the other ethnic groups may be because the hospitals in Sabah or Sarawak were not included in this pilot project.
Unknown
28/11/14 10:29 AM
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