Patient-Clinician Views Diverge in Psoriatic Arthritis Care

TOPLINE:

According to a recent study on patient and clinician perspective on the different aspects of psoriatic arthritis (PsA) care, patients and clinicians agree on core aspects such as joint pain and swelling, fatigue, disease activity, pain, physical function, and spine symptoms. However, unique perceptions of clinicians and patients were also reported.

METHODOLOGY:

• This study was conducted across three large clinical practices in the United States to understand differences in the concerns and priorities associated with PsA management among patients and clinicians.
• Four focus groups consisting of patients with PsA completed validated questionnaires on functional impairment, health-related quality of life, depression, and work productivity impact to identify disease attributes important to patients.
• Using deductive coding from the Psoriatic Arthritis Impact of Disease questionnaire and inductive coding for emerging themes, a comprehensive list of 51 PsA attributes was designed, with survey instructions specifying that participants distribute 100 points across these attributes.
• A total of 38 patients completed three rounds, and 13 clinicians completed two rounds of the Delphi exercise and answered the questionnaire on the basis of their perceived importance of different aspects of PsA.

TAKEAWAY:

• Both patients and clinicians ranked six items as their top priorities: Arthritis (joint pain and swelling), fatigue, disease activity, pain, physical function, and spine symptoms. Arthritis topped the list for both patients and clinicians, while the other five items had varying emphasis.
• Items uniquely prioritized by patients were stiffness, daily activities, sleep quality, access to care, and future health uncertainty.
• Clinicians placed a higher emphasis on specific disease manifestations, including dactylitis, enthesitis, psoriasis, comorbidities, and structural damage. They also prioritized disease management goals, focusing on patient-clinician communication.

IN PRACTICE:

“Understanding patient and clinician perspectives on PsA, especially when they differ, is vital to inform disease assessment, patient-clinician relationships, and shared decision-making in the clinic as well as in research endeavors,” the authors wrote.

SOURCE:

The study was led by Philip J. Mease, MD, Providence Swedish Medical Center, Seattle. It was published online on January 12, 2025, in ACR Open Rheumatology.

LIMITATIONS:

The study was limited by its focus on the United States, potentially missing perspectives from different healthcare systems. The inclusion of only a small number of patients with very active skin disease and recruitment solely from three rheumatology practices may not have represented the broader population in terms of ethnicity and social and economic status. Also, the majority of participants had private insurance, which potentially limited the inclusion of patients with other types of coverage.

DISCLOSURES:

This study was supported by an Investigator-Initiated Study Grant from Novartis Pharmaceuticals. No other conflicts of interest were reported.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.