Distinctive Variables From Sociodemographic, Physical Function, Social, and Psychoaffective Spheres Are Significantly Linked to the Perception of Mistreatment of Patients With Rheumatic Diseases.

Abstract

Background: Mistreatment adversely affects outcomes from patients with rheumatic diseases (RMDs). We previously observed that half of Mexican outpatients with RMDs perceived mistreatment. The study examines the factors associated with mistreatment.

Methods: This cross-sectional study was conducted at 2 academic urban centers for RMDs located in Mexico (June 28, 2023, to January 10, 2025). Consecutive outpatients completed the Mistreatment Scale adapted for RMDs, and additional patients reported outcome measures. Sociodemographic, disease-related variables, comorbid conditions, and treatment-related data were recorded using standardized formats. Mistreatment was defined when an individual's scale score was ≥1. If attributed to a specific RMD, it was classified as mistreatment related to RMD; this applied when a participant showed all patterns of mistreatment with a score of at least 1, linked to the underlying RMD. Participants showing 2 or more distinct patterns fall under the multiple mistreatment category. Multivariate regression analysis was used.

Results: We included 746 outpatients with RMDs. Most frequent diagnoses were rheumatoid arthritis (n = 251 [34%]) and systemic lupus erythematosus (n = 240 [32%]). In the 728 patients where the mistreatment construct could be assessed, 358 (49.2%) experienced mistreatment. Among them, 109 patients (30.4%) scored mistreatment related to RMD subcategory and n = 167 (46.6%) multiple mistreatment. We found that mistreatment and its categories were linked to distinctive variables across various human spheres, including sociodemographics, physical functioning, social relationships, and psychoaffective spheres.

Conclusions: Nearly 50% of the patients with RMD had the perception of mistreatment. This was linked to multiple variables including sociodemographics, physical functioning, social relationships, and mental health.