Misalignment between Physicians and Patient Satisfaction with Psoriatic Arthritis Disease ControlDaniel E Furst1*, Melody Tran2, Emma Sullivan3, James Pike3, James Piercy3, Vivian Herrera4 and Jacqueline B Palmer4
- *Corresponding Author:
- Daniel E. Furst
University of California, Los Angeles Los Angeles, California, USA
E-mail: [email protected]
Received date: August 31, 2016; Accepted date: October 06, 2016; Published date: October 13, 2016
Citation: Furst DE, Tran M, Sullivan E, Pike J, Piercy J, et al. (2016) Misalignment between Physicians and Patient Satisfaction with Psoriatic Arthritis Disease Control. Rheumatology (Sunnyvale) 6:206. doi:10.4172/2161-1149.1000206
Copyright: © 2016 Furst DE, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Objective: To evaluate the misalignment between psoriatic arthritis (PsA) patient- and physician-reported satisfaction with PsA control. Methods: Data came from the Adelphi Rheumatology Disease Specific Programme, a retrospective, cross-sectional survey of US-based rheumatologists and patients. Physicians provided satisfaction and clinical characteristics on tender joint count, swollen joint count, and percent body surface area (BSA) affected by psoriasis. Patients provided data on satisfaction, the Work Productivity Activity Impairment and HAQ-disability Index (HAQ-DI) questionnaires. Based on their satisfaction response, patient-physician pairs were classified into aligned (both satisfied or dissatisfied) or misaligned (rated satisfaction differently) groups. Multivariate analysis evaluated association of characteristics with misalignment. Results: Among 305 paired patient-physician records analyzed, 23.6% were misaligned and 76.4% were aligned. The misaligned group had shorter disease duration (mean years, 5.2 vs. 6.4), used fewer biologic disease-modifying antirheumatic drugs (49.3% vs. 62.9%), had more swollen (mean, 3.7 vs. 1.9, P=0.0002) and tender joints (mean, 5.6 vs. 2.9, P<0.0001), greater proportion of patients with comorbidities (72.2% vs. 63.1%) and >3% BSA affected by psoriatic skin lesions (64.2% vs. 55.1%). Misaligned patients reported greater work impairment (mean, 38.7 vs. 21.4, P=0.0004), daily activities (mean, 38.7 vs. 22.3, P<0.0001), and higher disease burden (mean HAQ-DI; 0.56 vs. 0.37, P=0.0001). Multivariate analysis found the number of swollen joints (P=0.02) and HAQ-DI score (P=0.03) were significantly associated with misalignment among all patients; however, not in the subgroup of employed patients. Conclusion: Patient-physician misalignment is associated with increased disease activity and disability among patients with PsA.