Session Information
Date: Sunday, November 8, 2015
Session Type: ACR Poster Session A
Session Time: 9:00AM-11:00AM
Background/Purpose:
Little is known about how psoriatic arthritis patients and their providers perceive response to therapy. Discrepancies in perceptions of therapy response may indicate that providers are not adequately measuring the aspects of disease that are meaningful to patients. Insufficient assessments of disease states may lead to non-ideal therapies and may contribute to patient non-compliance.
Methods:
Comparisons of patient and provider assessments of response to therapy formulate possible discrepancies. Of the 109 patients enrolled in the Psoriatic Arthritis Research Consortium (PARC) during August 2014 to June 2015, 64 patients rated their response(s) to therapy. Participants and their providers rated response to therapy on a 4-point scale (Very well, Moderately well, A little, Not at All). Participant response ratings were categorized as concordant if their rating was the same as the provider. Discordant participant responses were categorized as either less favorable or more favorable than the provider’s rating. Participant and disease characteristics were compared between participants with discordant and concordant ratings. These characteristics included age, gender, alcohol use, current smoker(s), Body Mass Index, education, disability, IBP, radiographic changes, and psoriatic fingernails.
|
Table 1. Baseline demographics, PsA characteristics, and therapies |
|
|
n=64 |
No. (%) or Mean (SD) |
|
Age |
53.0 (14.1) |
|
Female gender |
35 (54.7%) |
|
White race |
60 (93.8%) |
|
Ethnicity (hispanic/latino) |
2 (3.1%) |
|
Body Mass Index |
29.3 (7.5) |
|
Psoriatic arthritis duration from onset (years) |
13.7 (13.5) |
|
Psoriatic arthritis duration from diagnosis (years) |
6.6 (8.8) |
|
Synovitis documented by physician |
57 (89.1%) |
|
Dactylitis documented by physician |
12 (18.8%) |
|
Enthesitis documented by physician |
35 (54.7%) |
|
Inflammatory back pain |
20 (31.3%) |
|
Tender joint count (0-68) |
4.7 (8.2) |
|
Swollen joint count (0-66) |
1.6 (3.1) |
|
Classification Criteria for PsA diagnosis |
49 (76.6%) |
|
PGAxBSA |
1.8 (4.7) |
|
Peripheral radiographic changes consistent with PsA |
28 (43.8%) |
|
Axial radiographic changes consistent with PsA |
10 (15.6%) |
|
Biologic and non-biologic DMARDs, current |
52 (81.3%) |
|
Biologic and non-biologic DMARDs, past |
10 (15.6%) |
|
PGAxBSA = psoriasis Physician Global Assessment x Body Surface Area |
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Results: Forty percent of response ratings were concordant between participants and providers, while 29. 3% of participant ratings were less favorable than the provider ratings and 30.5% were more favorable.
| Table 2. Comparisons of patient and provider ratings | |||||
| Discordant ratings | |||||
| Concordant ratings (reference) | Less Favorable ratings | More Favorable ratings | |||
| n=18 | n=13 | p value or % change | n=17 | p value or % change | |
| Education (yrs) | 16.2 (2.9) | 14.8 (2.9) | 0.19 | 14.4 (2.5) | 0.06 |
| Age | 55.9 (15.5) | 49.1 (15.6) | 0.24 | 49.7 (11.0) | 0.19 |
| Body Mass Index | 30 (6.8) | 29.7 (8.2) | 0.93 | 28.5 (7.2) | 0.53 |
| Psoriatic fingernails | 4 (22.2%) | 7 (53.9%) | 31.7% | 10 (58.8%) | 36.6% |
| Inflammatory Back Pain | 6 (33.3%) | 3 (23.1%) | 10.2% | 4 (23.5%) | 9.8% |
| Peripheral radiographic changes | 7 (38.9%) | 6 (46.2%) | 7.3% | 8 (47.1)% | 8.2% |
| Axial radiographic changes | 1 (5.6%) | 2 (15.4%) | 9.8% | 4 (23.5%) | 17.9% |
| Female | 9 (50.0%) | 9 (69.2%) | 19.2% | 9 (53%) | 3.0% |
| Alcohol Use | 9 (50.0%) | 4 (30.8%) | 19.2% | 4 (23.5%) | 26.5% |
| Current Smokers | 0 (0.0%) | 1 (7.7%) | 7.7% | 1 (5.9%) | 5.9% |
| Disabled | 1 (5.6%) | 2 (15.4%) | 9.8% | 2 (11.8%) | 6.2% |
| Not working because of PsA | 0 (0.0%) | 0 (0.0%) | 0% | 3 (17.7%) | 17.7% |
| n=number of patients evaluated with rating | |||||
Conclusion:
Participants and providers rated response to therapy identically 40.2% of the time. Discordant response ratings were similarly distributed in the less favorable and more favorable categories. No differences in participant or disease characteristic were identified when discordant ratings were compared to concordant ratings.
To cite this abstract in AMA style:
Gunter T, Walsh J. Comparison of Patient and Provider Assessments of Response to Therapy for Psoriatic Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/comparison-of-patient-and-provider-assessments-of-response-to-therapy-for-psoriatic-arthritis/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-patient-and-provider-assessments-of-response-to-therapy-for-psoriatic-arthritis/