Determinants of Patient‐Physician Discordance in Global Assessment in Psoriatic Arthritis: A Multicenter European Study

Desthieux, Carole; Granger, Benjamin; Bălănescu, Andra; Bálint, Péter; Braun, Jürgen; Cañete, Juan D.; Heiberg, Turid; Helliwell, Philip S.; Kalyoncu, Umut; Kvien, Tore K; Kiltz, Uta; Niedermayer, Dora; Otsa, Kati; Scrivo, Rossana; Smolen, Josef S.; Stamm, Tanja; Veale, Douglas J.; Vlam, Kurt de; Wit, Maarten de; Gossec, Laure

doi:10.1002/acr.23172

Cited by 63 publications

(48 citation statements)

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“…Comorbidities such as chronic pain syndromes and mood disorders, which include fibromyalgia and depression, respectively, have been known to coexist with axSpA and may contribute to overestimation of patient‐reported symptoms such as pain scores, hence influencing discordance . Several studies in patients with spondyloarthritis suggest that factors associated with discordance were psychological rather than physical domains of health . In our study, none of the patients had chronic pain syndromes, so we were not able to determine if discordance between PGA and PhGA was affected by chronic pain syndromes.…”

Section: Discussionmentioning

confidence: 73%

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

et al. 2018

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Section: Discussionmentioning

confidence: 73%

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

et al. 2018

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“…The divergent opinions on treatment priorities and disease status between the patient and the physician [72][73][74][75] highlight the need to improve communication and patient-physician interactions. Indeed, patients report wanting ''to be understood as the whole person, not just the disease''.…”

Section: Improving Communication Between Patients and Physiciansmentioning

confidence: 99%

Improving the Management of Psoriatic Arthritis and Axial Spondyloarthritis: Roundtable Discussions with Healthcare Professionals and Patients

Garrido‐Cumbrera

Hillmann²,

Mahapatra

et al. 2017

Rheumatol Ther

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Psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA) are both chronic, inflammatory conditions that result in a substantial burden of disease and reduced quality of life for patients. Patient involvement in developing optimal disease management strategies, including defining appropriate goals, therapies, and treatment options, as well as in setting policy priorities and agendas, is key. A working group of patient organization representatives and rheumatologists explored what patients consider to be unmet needs, important treatment gaps, and future priorities in PsA and AxSpA management. Reducing pain and fatigue, and improving physical and social functioning and work productivity were identified as important treatment goals for patients. Although the major treatment target for both PsA and AxSpA is remission, with low/minimal disease activity an alternative target for patients with established or long-standing disease, the meaning of remission from the patient’s perspective needs to be explored further as it may differ considerably from the physician’s perspective. Key recommendations from the working group to tackle unmet needs included reducing time to diagnosis, increasing patient and physician disease awareness, focusing on patients’ priorities for treatment goals, and improving patient–physician communication. By addressing these key action points moving forward, the hope is that outcomes will continue to improve for patients with PsA and AxSpA.

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“…Patient-reported outcomes measures (PROMs), such as those provided by the PsAID questionnaire, have been found to be a reliable indicator of change during treatment, predictive of long-term outcomes, and the impact of PsA on patients' lives [5][6][7]. Discrepancy between patient's and physician's ratings of general health status has been demonstrated [8][9][10]. In PsA, factors associated with discordance were psychological rather than physical and were more frequent in patients in remission [10].…”

Section: Introductionmentioning

confidence: 99%

“…Discrepancy between patient's and physician's ratings of general health status has been demonstrated [8][9][10]. In PsA, factors associated with discordance were psychological rather than physical and were more frequent in patients in remission [10]. The consequence of such a discordant viewpoint with regard to disease activity is that decisions are often prone to not being shared between patients and physicians [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…In PsA, factors associated with discordance were psychological rather than physical and were more frequent in patients in remission [10]. The consequence of such a discordant viewpoint with regard to disease activity is that decisions are often prone to not being shared between patients and physicians [8][9][10]. The patients' own perspectives of their health status may therefore be an important additional measure to assess the level of disease activity and for clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

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Disease features associated with a low disease impact in patients with psoriatic arthritis: results of a cross-sectional multicenter study

et al. 2020

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on behalf of the MAAPS study groupAbstract Background: Patient-reported outcomes measures, such as those provided by the Psoriatic Arthritis Impact of Disease (PsAID) questionnaire, have been found to be a reliable indicator of change during treatment, predictive of long-term outcomes, and the impact of psoriatic arthritis (PsA) on patients' lives. The objective of the study was to describe the demographic and clinical characteristics of PsA patients with a low disease impact and to analyze predictive factors for that state. Methods: Post hoc analysis of a cross-sectional multicenter study that included 223 consecutive patients. PsAID questionnaire was used to estimate disease impact. Patients with a PsAID < 4 were considered in low disease impact. Minimal disease activity (MDA) response and the Health Assessment Questionnaire (HAQ) were also assessed. The degree of agreement between the different outcomes was addressed by Cohen's kappa index. Results: One hundred and twenty-two (54.7%) patients reached a PsAID < 4. Among them, 52.0% and 68.0% presented articular or skin remission, respectively. Almost 75% of patients were in MDA state and 85.2% presented a low disability state according to the HAQ. A moderate concordance between HAQ ≤ 0.5 and PsAID < 4 (k = 0.53), fair between MDA and PsAID < 4 (k = 0.36), and moderate between DAPSA remission and PsAID < 4 (k = 0.46) was observed. Multivariate logistic regression analysis showed that patients with distal interphalangeal joint (DIP) disease (OR 0.40, 95%CI, 0.20-0.79, p = 0.009), family history of PsA (OR 0.25, 95%CI, 0.09-0.72, p = 0.010), and higher Creactive protein (OR 0.92, 95%CI, 0.85-0.99, p = 0.036) were significantly less likely to reach a PsAID < 4. Conclusions: There is certain discrepancy between disease activity measures and a low impact of disease in PsA. Clinical features (DIP joint involvement), biologic activity, and genetic factors (familial history) seem to be associated with lower odds of reaching a low disease impact.

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Determinants of Patient‐Physician Discordance in Global Assessment in Psoriatic Arthritis: A Multicenter European Study

Cited by 63 publications

References 12 publications

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective

Improving the Management of Psoriatic Arthritis and Axial Spondyloarthritis: Roundtable Discussions with Healthcare Professionals and Patients

Disease features associated with a low disease impact in patients with psoriatic arthritis: results of a cross-sectional multicenter study

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