Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Patient (pt)–rheumatologist (rheum) communication may influence symptom reporting and disease control in psoriatic arthritis (PsA). This online survey evaluated pt–rheum communication and assessed PsA symptoms/life impact and satisfaction in pts who reported good/suboptimal communication.
Methods: The survey was conducted in the USA from Nov 2 to Dec 1 2017 (pts) and Dec 11 2017 to Jan 25 2018 (rheums). Eligible pts (≥18 years) self-reported having had PsA for >1 year, had visited a rheum or dermatologist in the past year, and reported using ≥1 synthetic(s)/biologic(b) DMARD for PsA. Rheums saw ≥10 PsA pts/month with ≥50% of pts receiving a s/b DMARD. Differences in pt-reported PsA impacts are evaluated by pt–rheum communication status (Table). Analyses are based on descriptive statistics and two-tailed tests for proportions.
Results: In total, 301 pts with PsA responded, mean (SD) age 45 (14.2) years, 61% female, 89% self-reported moderate/severe PsA. 256 pts (85%) were managed by a rheum and are the focus of this analysis. Most pts (93%) and rheums (88%) were satisfied with their current communication. Over 40% of pts reported aspects of suboptimal pt–rheum communication that may impact satisfaction (Table). Overall, 93% of pts were comfortable raising concerns/fears (acknowledged by 94% of rheums) while pts with suboptimal communication were less comfortable doing so (Table). Rheums generally demonstrated good understanding of PsA-related pt worries, and rheums and pts (50% and 52%, respectively) identified ability to perform activities of daily living and/or live independently as a key concern. The negative impact of PsA on physical activity, emotional/mental well-being, work productivity, and romantic relationships/intimacy was considered major/moderate by most rheums (88%, 79%, 75%, 59%, respectively) in alignment with pt reports (80%, 66%, 61%, 55%, respectively). In suboptimal communication pt groups, the impact of PsA on aspects of HRQoL was greater than in good communication groups (Table; p<0.05). Overall, rheums expressed a desire for greater pt understanding of PsA symptoms (86%) and consequences of untreated PsA (88%) and pts expressed a desire to discuss PsA and treatment goals; however, pts with suboptimal communication were less likely to share PsA symptoms with their rheum (Table).
Conclusion: The majority of pts and rheums were satisfied with communication, and rheums were generally aware of pts’ worries and impact of PsA on HRQoL. Over 40% of pts reported communication gaps. Pts who reported suboptimal communication were more reluctant to discuss symptoms, ask questions, or share concerns/fears and experienced a greater impact of PsA on HRQoL. Pts reported that rheums did not devote sufficient time to discuss treatment goals. Communication tools may facilitate shared decision-making.
To cite this abstract in AMA style:Orbai AM, Coates LC, Azevedo VF, Garg A, Majjhoo A, Griffiths CEM, Young P, Cappelleri JC, Moser J, Fallon L. A Link between Quality of Patient–Rheumatologist Communication and Patient Healthcare Needs in Psoriatic Arthritis: An Online Survey of US-Based Patients and Rheumatologists [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/a-link-between-quality-of-patient-rheumatologist-communication-and-patient-healthcare-needs-in-psoriatic-arthritis-an-online-survey-of-us-based-patients-and-rheumatologists/. Accessed April 9, 2020.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-link-between-quality-of-patient-rheumatologist-communication-and-patient-healthcare-needs-in-psoriatic-arthritis-an-online-survey-of-us-based-patients-and-rheumatologists/