The Psoriatic Arthritis Experience in Saudi Arabia from the Rheumatologist and Patient Perspectives

Abstract

Background: Psoriatic arthritis (PsA) is a musculoskeletal disease that adversely affects physical mobility and quality of life. It is challenging to manage because of the heterogeneous na-ture of the symptoms and the current treatment options. To explore the patient and rheumatologist perspectives of PsA to help improve understanding of the disease experience and improve disease management Methods: A descriptive, observational cross-sectional study of Saudi Arabian dermatologists and rheumatologists and patients with psoriasis or PsA was conducted. Questionnaire data were collect-ed from 31 dermatologists, 34 rheumatologists, 90 patients with psoriasis, and 98 patients with PsA and analysed using descriptive statistics. Here, data from rheumatologists and patients with PsA are presented. Results: The results revealed similarities and differences in the rheumatologist and patient perspec-tives of PsA. Rheumatologists and patients agreed on the impact that PsA had on patients’ quality of life and that more education was needed. However, they differed on several aspects of disease man-agement. Rheumatologists estimated the time to diagnosis as four times shorter than what patients experienced. Patients accepted their diagnosis more than rheumatologists perceived them to; rheu-matologists perceived patients to be worried or fearful. Patients perceived joint pain as their most severe symptom, in contrast to rheumatologists, who presumed skin appearance was the most severe symptom. Reported input into PsA treatment goals differed significantly. More than half of the rheumatologists reported equal patient-physician input into goal development as opposed to <10% of patients reporting the same. Almost half of patients reported no input into the development of their treatment goals. Conclusion: The management of PsA could benefit from enhanced screening and re-evaluation of what PsA outcomes have the most value to patients and rheumatologists. A multidisciplinary ap-proach is recommended with increased patient involvement in disease management and individual-ized treatment options. conclusion: The management of PsA could benefit from enhanced screening and re-evaluation of what PsA outcomes have the most value to both patients and rheumatologists. A multidisciplinary approach is recommended with increased patient involvement in disease management and individualized treatment options.

Experiences of Dermatologists and Patients Regarding Psoriasis and Its Connection to Psoriatic Arthritis in Saudi Arabia

“…The authors of this paper previously published the perspectives of rheumatologists and patients with psoriatic arthritis. 16 While both dermatologists and rheumatologists acknowledge that these populations are underdiagnosed, patients with psoriasis were diagnosed in approximately one-third of the time taken to achieve diagnosis in patients with psoriatic arthritis (20 months versus 64 months), and those with psoriasis saw a specialist in less than half the time than patients with psoriatic arthritis (2.5 months versus 6 months). 16 Although an increasing number of dermatologists do consider patient QoL when deciding on a treatment choice, 30 the percentage remains low (28%).…”

“… 33 Once progression to psoriatic arthritis occurs, the percentage of highly satisfied patients decreases even further to 22%. 16 Some suggest that the ideal treatment goals should be pre-defined by the patient and individualized in a tailor-made treatment program, 9 while others suggest a collaborative approach between physicians and patients to reach the goal of minimal disease activity. 16 The need to incorporate patients in treatment decision-making is again highlighted here.…”

“…Data collected from rheumatologists and patients with psoriatic arthritis have been published separately. 16 …”

“… 9 , 23 , 24 Patients with psoriatic arthritis have unique and different treatment goals for psoriasis, and while treatments are usually initiated quickly, satisfaction levels with psoriatic arthritis care remain low. 16 …”

“…A concurrent study exploring the experiences of patients with psoriatic arthritis and rheumatologists was conducted, the results of which have been previously published. 16 …”