Psoriatic Arthritis Patients Often Disagree with Rheumatologists on Disease Activity, Study Suggests

Psoriatic Arthritis Patients Often Disagree with Rheumatologists on Disease Activity, Study Suggests

Psoriatic arthritis patients’ perception of their disease activity is often different from their rheumatologists, according to the results of a new analysis.

The study, “Misalignment between physicians and patient satisfaction with psoriatic arthritis disease control,” was published in the journal Clinical Rheumatology.

Psoriatic arthritis symptoms are heterogeneous, and some patients might be burdened more with certain symptoms when compared to others. This heterogeneity may influence their perception on disease activity. The disease is currently assessed by patient-reported outcomes combined with physicians’ evaluation of patients’ clinical and laboratory parameters.

However, since “a patient’s point of view is typically based on their experience with psoriatic arthritis over a long period of time, while a physician’s perception of psoriatic arthritis activity is related to his or her professional experience,” this may result in different perceptions of disease activity between the patient and the physician.

In the study, authors evaluated the differences between psoriatic arthritis patients and physicians’ reports on treatment satisfaction. They analyzed data from a retrospective study, the Adelphi Disease Specific Program, which includes reports from U.S.-based rheumatologists and patients.

Specifically, physicians reported on patients’ clinical characteristics on tender joint count, swollen joint count, and percent of body surface area (BSA) affected by the disease.

The patients’ points of view were determined through satisfaction questionnaires, including the Work Productivity Activity Impairment and Health Assessment Questionnaire-Disability Index (HAQ-DI).

“Based on their satisfaction response, patient-physician pairs were classified into aligned (both satisfied or dissatisfied) or misaligned (rated satisfaction differently) groups,” the authors explained.

A total of 305 paired patient-physician records were analyzed. While 76.4% of the reports were aligned, the opposite was found in 23.6% of the cases, with physicians and their psoriatic arthritis patients issuing different reports.

“The misaligned group reported significantly more psoriatic arthritis symptoms, indicating increased psoriatic arthritis activity compared with that of the aligned group. The percentage of patients with comorbidities was also higher in the misaligned than that of the aligned group,” authors wrote.

In general, the misalignment was due to physician dissatisfaction with their patients’ disease control, while the majority of patients were satisfied. Specifically, the disparity was associated with increased disease activity and disability among patients with psoriatic arthritis.

Overall, these results suggest that a fraction of psoriatic arthritis patients report differences in their satisfaction over disease control when compared to their rheumatologists.

“Our findings stress the importance of strong and effective communication between patients and their physicians in treating this chronic disease,” the authors concluded.

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Patricia holds her Ph.D. in Cell Biology from University Nova de Lisboa, and has served as an author on several research projects and fellowships, as well as major grant applications for European Agencies. She also served as a PhD student research assistant in the Laboratory of Doctor David A. Fidock, Department of Microbiology & Immunology, Columbia University, New York.

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