Discordance between patient and physician global assessments of psoriatic arthritis activity: an observational study in 13 Arab countries.

IF 3.2 3区医学 Q2 RHEUMATOLOGY Rheumatology International Pub Date : 2025-03-12 DOI:10.1007/s00296-025-05819-1

Noura Abbas, Ihsane Hmamouchi, Lina El Kibbi, Avin Maroof, Bassel Elzorkany, Nizar Abdulateef, Asal Adnan, Nabaa Ihsan, Faiq Isho Gorial, Nada Al Chama, Chafika Haouichat, Fatima Alnaimat, Suad Hannawi, Saed Atawnah, Hussein Halabi, Manal Al Mashaleh, Laila Aljazwi, Ahmed Abogamal, Laila Ayoub, Elyes Bouajina, Rachid Bahiri, Sahar Saad, Maha Sabkar, Krystel Aouad, Nelly Ziadé, Laure Gossec

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Abstract

Discordance between physicians and patients in assessing psoriatic arthritis (PsA) activity is common and might impact treatment adherence and decision-making. Cultural and belief systems may influence this discordance. This study aimed to assess the extent of patient-physician discordance in PsA in Arab countries and its association with demographic and disease characteristics.The TACTIC study was a cross-sectional observational study across 13 Arab countries in 2022. Patient and physician global assessments (PGA, PhGA) of disease activity (0-10 scale) were collected, along with demographic and disease data, Disease Activity in Psoriatic Arthritis (DAPSA), and Psoriatic Arthritis Impact of Disease (PsAID). Discordance was defined as an absolute difference of |PGA-PhGA|> 2. Its association with patient characteristics was analyzed through multivariable multinomial logistic regression. In 538 patients (317 females, 58.9%), with a mean age of 45.5 ± 13.2 years and PsA duration of 8.8 ± 7.3 years, the disease was moderately active (mean DAPSA 19.3 ± 16.1; mean PsAID 3.86 ± 2.33). Mean PGA was higher than mean PhGA (4.7 ± 2.5 versus 4.0 ± 2.4, p < 0.001) with an absolute difference of 1.30 ± 1.41 and a high correlation between global assessments (r = 0.74). Discordance was infrequent, occurring in 84 patients (15.6%), and was mostly due to higher PGA (70/84, 83.3%). Discordance (one-point increase) was associated with a lower PhGA (Odds ratio (OR) 3.03 [95%CI 2.18-4.22]), positive fibromyalgia screening (OR 1.28 [95%CI 1.03-1.58]), higher DAPSA (OR 1.16 [95%CI 1.03-1.09]), and higher PsAID scores (OR 2.63 [95%CI 1.96-3.54]). Discordance was primarily identified in patients with moderate disease activity. Discordance between PGA and PhGA was infrequent in Arab countries, suggesting strong patient-physician alignment. Expectations and disease perceptions may play a role in this discordance.

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来源期刊

Rheumatology International 医学-风湿病学

CiteScore

7.30

自引率

5.00%

发文量

191

审稿时长

16. months

期刊介绍： RHEUMATOLOGY INTERNATIONAL is an independent journal reflecting world-wide progress in the research, diagnosis and treatment of the various rheumatic diseases. It is designed to serve researchers and clinicians in the field of rheumatology. RHEUMATOLOGY INTERNATIONAL will cover all modern trends in clinical research as well as in the management of rheumatic diseases. Special emphasis will be given to public health issues related to rheumatic diseases, applying rheumatology research to clinical practice, epidemiology of rheumatic diseases, diagnostic tests for rheumatic diseases, patient reported outcomes (PROs) in rheumatology and evidence on education of rheumatology. Contributions to these topics will appear in the form of original publications, short communications, editorials, and reviews. "Letters to the editor" will be welcome as an enhancement to discussion. Basic science research, including in vitro or animal studies, is discouraged to submit, as we will only review studies on humans with an epidemological or clinical perspective. Case reports without a proper review of the literatura (Case-based Reviews) will not be published. Every effort will be made to ensure speed of publication while maintaining a high standard of contents and production. Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1964 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted.