Impact of Patient with Patient Interaction on Perceived Rheumatoid Arthritis Overall Disease Status

Abstract

To determine whether patient interaction impacts on perceived disease severity and ability to cope with rheumatoid arthritis (RA) forty RA patients were assessed using joint counts, clinician global assessment, patient global assessment (PGA), VAS pain scale and Health Assessment Questionnaire (HAQ). All participants had six one-on-one conversations about their disease activity and the effect of RA on their lives. Follow-up questionnaires asked about recall of pre-conversation PGA; post-conversation PGA; change in PGA; and change in ability to cope as a result of the conversations. 87.5% of the questionnaires were returned. Pre- and post-conversation PGA were statistically reliable; PGA score improved (P = 0.004); 60.0% of participants felt their ability to cope with their disease improved as a result of this interaction. RA patients benefit from sharing information with like patients. Support groups may be an integral part of treatment strategy in patients with RA.

The impact of arthritis on daily life with the patient perspective in focus

“…A common feeling can be a sense of alienation in communicating with people who do not really comprehend the ramifications of the disease, and also discontent with the lack of opportunity to talk about the disease with people who actually face the same challenges and frustrations. Interaction with other RA patients led to improved coping ability (30). Sharing experiences has perhaps been undervalued as a worthwhile intervention for patients with arthritis, but patient education programmes can have an inherent social and sharing component as well as reducing symptoms (19, 25, 31).…”

“…‘What the patient brings to the illness appears to be more important than the illness itself’. Psychosocial status has been found to be related to disability almost to the same extent as the biological disease manifestations do (30).…”

Are there more than cross‐sectional relationships of social support and support networks with functional limitations and psychological distress in early rheumatoid arthritis? The European Research on Incapacitating Diseases and Social Support Longitudinal Study

“…Among intervention studies in RA patients involving support groups, Baker et al generated directed one‐on‐one conversations between RA patients about their disease activity and its impact on their lives (46). More positive feelings regarding disease activity and ability to cope with it were observed after the conversations.…”

Measures of rheumatoid arthritis disease activity: Patient (PtGA) and Provider (PrGA) Global Assessment of Disease Activity, Disease Activity Score (DAS) and Disease Activity Score With 28‐Joint Counts (DAS28), Simplified Disease Activity Index (SDAI), Clinical Disease Activity Index (CDAI), Patient Activity Score (PAS) and Patient Activity Score‐II (PASII), Routine Assessment of Patient Index Data (RAPID), Rheumatoid Arthritis Disease Activity Index (RADAI) and Rheumatoid Arthritis Disease Activity Index‐

“…Duration of morning stiffness does not correlate with PtGA (21) and when compared to the DAS28, the PtGA was 41% more likely to be concordant than discordant (15). Education may affect patient ratings of disease activity (14), comorbid disease increases the PtGA (14), and support groups may decrease PtGA (22). In a study of 24 patients, the PrGA correlated with the PtGA and pain scores (R = 0.2–0.7), with the Health Assessment Questionnaire (HAQ; R = 0.3–0.7), and with ESR (R = 0.2–0.4) (23).…”

“…As the PtGA and PrGA are overall measures of patient well‐being, the effects of comorbid illness (26) and fixed damage, in addition to current RA disease activity, may influence the score. The PtGA may be more a measure of quality of life than of disease activity as it is decreased after participation in support groups (22) and is influenced by patient education (14). Although the PtGA is a component of many composite measures, when used alone it lacks face validity as no provider‐derived data or laboratory parameters are included.…”