ARP Rheumatology
ARP Rheumatology
+

Article

ARP Rheumatology
Original article

Patient-Physician discordance in assessment of disease activity in Rheumatoid Arthritis patients

Authors

Brites L, Freitas JDd, Costa F, Luís M, Prata AR, Assunção H, Saraiva L, Sousa M, Ferreira R, Santiago M, Silva Jd, Duarte C

Abstract

Background. In rheumatoid arthritis (RA), global disease activity is commonly evaluated, from the patient’s and the physician’s perspective, through a 100mm visual analogue scale (VAS) and plays an important role in the assessment of diseases activity and treatment decisions. Our aim was to determine patient-physician discordance in the assessment of disease activity and to explore its determinants. Methods. Cross sectional study including RA patients (ACR/EULAR 2010 classification criteria). The discrepancy between patients-physicians (∆PPhGA) was defined as PGA minus PhGA, and a difference > |20mm| was considered as “discordant”. Correlation between ∆PPhGA and other variables was assessed through Pearson’s correlation and comparison between groups through t-test. Variables with p < 0.05 or considered clinically relevant were included in multivariable linear regression analysis to identify determinants for ∆PPhGA. A p < 0.05 was considered statistically significant. Results. In total, 467 patients with RA were included (81.2% female; mean age 63.9% ± 12.2 years). PGA and PhGA were discordant in 61.7% of the cases. The proportion of concordance increased (p < 0.01) when considering only patients in remission (DAS 28 3V < 2.6). In multivariable analysis (R2adjusted=0.27), VAS-pain-patient (β 0.74, 95% CI 0.62-0.88, p=0.00) and TJC (β 0.16, 95% CI 0.45-0.48, p=0.02) remained associated with a higher ∆PPhGA. Conclusion. Our study confirmed that a significant discrepancy between patients and physicians in the assessment of global disease activity is frequent in clinical practice, and is probably due to valorization of different parameters by the two groups.

Share

 

Publication:

2021-01-24

Pubmed:

Cite:

Luisa Brites, João Dinis de Freitas, Flávio Costa, Mariana Luís, Ana Rita Prata, Helena Assunção, Liliana Saraiva, Marlene Sousa, Ricardo Ferreira, Mariana Santiago, José da Silva, Cátia Duarte. Patient-Physician discordance in assessment of disease activity in Rheumatoid Arthritis patients. ARP, Vol 46, nº2 2021:103-109. PMID: 34226435
Copy citation

This browser does not support PDFs. Please download the PDF to view it: Download PDF.