Discordance between patient and physician global assessments amongst South Africans with rheumatoid arthritis
Résumé
Background Patient and physician global assessments (PGA and PhGA) in Rheumatoid Arthritis (RA) play a crucial role in treatment decisions, yet discordance in these assessments is common. Factors influencing PGA and PhGA and discordance in South African (SA) patients remain poorly understood. Methods This cross-sectional study included consenting adults with RA attending a tertiary hospital. Demographic, disease-specific, and patient-reported outcome data were collected. A discordance score was calculated by subtracting the PhGA score from the PGA score, and discordance was defined as PGA-PhGA ≥2.5. Determinants of PGA and PhGA were explored using univariate Spearman correlation and multivariable linear stepwise regression. Results Of 550 patients, most were female (84.9%), with a mean (SD) age and disease duration of 55.8 (12.9) and 11.5 (9.7) years. Discordance was seen in 27.5%. Pain severity significantly influenced PGA, while swollen joint count predominantly influenced PhGA. A large portion of the variance in PGA and PhGA (61.7% and 48.5% respectively) was unexplained. Patients with discordance reported higher pain scores, and problems with usual activities but had lower swollen joint counts and were more likely to be in remission or low disease activity than concordant patients. Conclusion Discordance in patient-physician assessments exists in a considerable proportion of SA RA patients. Pain severity and functional limitations greatly influence patient perceptions. Addressing pain and activity limitations may help reduce discordance, optimize disease management, and foster shared decision-making. Further longitudinal and qualitative research is warranted for a more comprehensive understanding of our RA patients’ perspectives.
Citer ce document
Accès au document
Texte intégral en lecture en ligne, réservé aux abonnés SPHAERO et aux membres de l'institution. Se connecter
Voir l'article sur le site de la revueAuteur(s)
Statistiques
Consultations : 1
Téléchargements : 0