Misalignment between physicians, patients associated with increased psoriatic arthritis disease activity
Misalignment in patient- and physician-reported satisfaction with disease control was associated with an increased risk for disease activity in patients with psoriatic arthritis, according to recently published data.
Daniel E. Furst, MD, in the Department of Rheumatology at UCLA Medical Center, and colleagues used data from the Adelphi Rheumatology Disease Specific Programme of 305 patient and physician pairs to obtain physician reports on satisfaction and clinical characteristics of tender joint count, swollen joint count and percent body surface area (BSA) affected by psoriasis, as well as patient reports on satisfaction, the Work Productivity Activity Impairment and Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaires. Researchers considered patient and physician pairs to be misaligned if they rated satisfaction differently.
They found 23.6% of pairs were misaligned and 76.4% were aligned. Patients in the misaligned group had a shorter disease duration (5.2 years vs. 6.4 years) and had fewer biologic disease-modifying antirheumatic drugs taken (49.3 vs. 62.9%); but they had more swollen joints (3.7 vs. 1.9), more tender joints (5.6 vs. 2.9), a higher percentage of patients with comorbidities (72.2% vs. 63.1%) and a higher percentage of patients with at least 3% BSA (64.2% vs. 55.1%). In addition, misaligned patients reported greater impairment in work (38.7 HAQ-DI score vs. 21.4), daily activities (38.7 HAQ-DI score vs. 22.3) and a greater disease burden (0.56 HAQ-DI score vs. 0.37). In addition, the number of swollen joints and HAQ-DI score was significantly associated with misalignment, except for a subgroup of employed patients. In addition, misalignment was linked with increased disease activity and disability among patients with psoriatic arthritis.
“Our findings stress the importance of strong and effective communication between patients and their physicians in treating this chronic disease,” the researchers wrote. – by Will Offit
Disclosures: Researchers report funding by Novartis. Please see the full study for a list of all other relevant financial disclosures.