Patient-physician discordance in global assessment in early spondyloarthritis and its change over time: the DESIR cohort

Abstract

Discordance concerned a quarter of patients with early axSpA. Over 3 years of follow-up, discordance did not decrease (no 'reference shift'). Discordance was not a stable trait, indicating discordance is not a patient characteristic.

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

“…Education level was classified into pre‐secondary, which included no formal education and primary education level (≤ 6 years of formal education) and post‐secondary, which included secondary and tertiary education levels (> 6 years of formal education). Other studies have used similar demographic data . In addition, clinical and laboratory data such as human leukocyte antigen (HLA)‐B27 status, erythrocyte sedimentation rate (ESR), C‐reactive protein (CRP) and global pain score via 0–100 mm VAS were obtained.…”

“…AxSpA may persist throughout life, resulting in significant loss of function, disability and decreased quality of life thus reflecting the importance of appropriate management . While management of axSpA should be based on a shared decision between the patient and the physician, patient's perspectives on disease activity are not always similar to the physician's perspective, resulting in discordance . Discordance occurs when there is a difference in assessment of disease activity between patient and physician, and this may pose a challenge during shared decision making regarding further treatment plans.…”

“…In axSpA, there are limited studies regarding patient–physician discordance and none of the studies were based on Asian populations . Singapore is a multiethnic Asian country with the majority being Chinese (74.1%), followed by Malay (13.4%), Indian (9.2%) and others (3.3%) .…”

“…Singapore is a multiethnic Asian country with the majority being Chinese (74.1%), followed by Malay (13.4%), Indian (9.2%) and others (3.3%) . Previous studies based on Western populations have identified factors such as functional disability, global pain score, fatigue and spine pain to be determinants of discordance between patient global assessment (PGA) and physician global assessment (PhGA) …”

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

“…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''.…”