Promoting patient‐centred care in psoriatic arthritis: a multidisciplinary European perspective on improving the patient experience

Abstract

Patients with psoriatic arthritis (PsA) may not be optimally treated. The impact of the disease extends beyond skin and joint symptoms, impairing quality of life. This indicates that the adoption of a patient‐focused approach to PsA management is necessary. An expert multidisciplinary working group was convened, with the objective of developing an informed perspective on current best practice and needs for the future management of PsA. Topics of discussion included the barriers to current best practice and calls to action for the improvement of three areas in PsA management: early and accurate diagnosis of PsA, management of disease progression and management of the impact of the condition on the patient. The working group agreed that, to make best use of the available of diagnostic tools, clinical care recommendations and effective treatments, there is a clear need for healthcare professionals from different disciplines to collaborate in the management of PsA. By facilitating appropriate and rapid referral, providing high quality information about PsA and its treatment to patients, and actively involving patients when choosing management plans and setting treatment goals, management of PsA can be improved. The perspective of the working group is presented here, with recommendations for the adoption of a multidisciplinary, patient‐focused approach to the management of PsA.

Current Psychosomatic Practice

“…Multidisciplinary services have been developed within specialties and subspecialties such as oncology, cardiology, dermatology, gynecology, nephrology, gastroenterology, organ transplantation, and endocrinology [219,220,221,222]. Such services may be operated by various specialists (group approaches) or by a single specialist with a multidisciplinary background.…”

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

“…The Inflammatory Back Pain (IBP) Experts' Criteria are robust, easy to apply, and have been validated in the international ASAS study on new classification criteria for AxSpA [41]. Therefore, these criteria, where at least four of five of the following parameters are present: (1) age at onset no greater than 40 years; (2) insidious onset; (3) improvement with exercise; (4) no improvement with rest; and (5) pain at night (with improvement upon getting up), are recommended for defining IBP in the ASAS-endorsed recommendations for early referral [21]. Whether these recommendations will prove useful for different non-rheumatic referring specialists has yet to be demonstrated.…”

“…As the impact of both PsA and AxSpA for patients is far-reaching, beyond simply musculoskeletal symptoms that are often the primary focus of most rheumatology guidelines, a patient-centered approach is imperative when developing recommendations or choosing suitable treatment targets [21].…”

Depression in Psoriatic Arthritis: Dimensional Aspects and Link with Systemic Inflammation

“…Depression and anxiety were not associated with inflammatory markers and swollen joint count during follow-up [40]. Adherence to treatment is more difficult in PsA patients with comorbid depression, which interferes with treat-to-target strategies and the achievement of a minimal disease activity state [41]. A study using data from the Danish Biological Registry (DANBIO), which included 1750 patients with PsA, noted that patients with depression and/or anxiety showed shorter persistence on TNF inhibitors (TNFi) than did those without comorbidities [42].…”