Patients with PsA who are misaligned with their physicians may have worse outcomes

Misalignment in disease perception between patients with psoriatic arthritis and their treating rheumatologists may result in worse outcomes and higher disease activity in patients, according to recently presented data.

Researchers studied data from 305 rheumatologist and psoriatic arthritis (PsA) patient pairs in the United States from the Adelphi 2011 and 2014 Rheumatology Disease Specific Programmes.

Daniel Furst

Patients were administered the Work Productivity Activity Impairment and alternative health assessment questionnaire disability index (excluding aids and devices) questionnaires, and both patients and physicians reported their satisfaction with treatment.

Calculations showed the level of alignment of satisfaction between patients and rheumatologists was 76.4%, with satisfaction with treatment among both groups at 65.3% and dissatisfaction at 11.1%. Physician and patient misalignment was present in 23.6% of the study group. Patients in the aligned and misaligned pairs were similar for age and sex, but the misaligned group had a shorter time since diagnosis and were less likely to receive biologic therapy.

Patients in the misaligned group had higher total tender and swollen joint counts, body surface area affected and more PsA symptoms. Common comorbidities included hypertension, hyperlipidemia and obesity. Higher incidence of depression, anxiety, and overall work and daily activity impairment were present among misaligned patients. Patients misaligned with their physician also had higher disability as evidenced by the alternative health assessment questionnaire disability index score.

“The findings suggest that a greater degree of alignment might result in improved outcomes, although further research would be required to verify this hypothesis,” the researchers wrote. - by Shirley Pulawski

Reference:

Furst DE, et al. Paper #682. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosures: Furst reports financial arrangements with AbbVie, Actelion Pharmaceuticals US, Amgen, Biogen Idec, Bristol-Myers Squibb, Cytori, Genentech, Gilead, GlaxoSmithKline, Janssen, Novartis Pharmaceutical Corporation, Pfizer Inc., Roche Pharmaceuticals and UCB. Please see the full study for a list of all other authors’ relevant financial disclosures.