Journal article
Determinants of discordance in patients' and physicians' rating of rheumatoid arthritis disease activity
Arthritis care & research (2010), v 64(2), pp 206-214
Feb 2012
PMID: 22052672
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Objective To assess the determinants of patients' (PTGL) and physicians' (MDGL) global assessment of rheumatoid arthritis (RA) activity and factors associated with discordance among them.
Methods. A total of 7,028 patients in the Quantitative Standard Monitoring of Patients with RA study had PTGL and MDGL assessed at the same clinic visit on a 0-10-cm visual analog scale (VAS). Three patient groups were defined: concordant rating group (PTGL and MDGL within >= 2 cm), higher patient rating group (PTGL exceeding MDGL by > 2 cm), and lower patient rating group (PTGL less than MDGL by > 2 cm). Multivariable regression analysis was used to identify determinants of PTGL and MDGL and their discordance.
Results. The mean +/- SD VAS scores for PTGL and MDGL were 4.01 +/- 2.70 and 2.91 +/- 2.37, respectively. Pain was overwhelmingly the single most important determinant of PTGL, followed by fatigue. In contrast, MDGL was most influenced by swollen joint count (SJC), followed by erythrocyte sedimentation rate (ESR) and tender joint count (TJC). A total of 4,454 (63.4%), 2,106 (30%), and 468 (6.6%) patients were in the concordant, higher, and lower patient rating groups, respectively. Odds of higher patient rating increased with higher pain, fatigue, psychological distress, age, and morning stiffness, and decreased with higher SJC, TJC, and ESR. Lower patient rating odds increased with higher SJC, TJC, and ESR, and decreased with lower fatigue levels.
Conclusion. Nearly 36% of patients had discordance in RA activity assessment from their physicians. Sensitivity to the "disease experience" of patients, particularly pain and fatigue, is warranted for effective care of RA.
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Details
- Title
- Determinants of discordance in patients' and physicians' rating of rheumatoid arthritis disease activity
- Creators
- Nasim A. Khan - University of Arkansas for Medical SciencesHorace J. Spencer - University of Arkansas for Medical SciencesEsam Abda - Sohag UniversityAmita Aggarwal - Sanjay Gandhi Post Graduate Institute of Medical SciencesRieke Alten - MSB Medical School BerlinCodrina Ancuta - Grigore T. Popa University of Medicine and PharmacyDaina Andersone - Pauls Stradiņš Clinical University HospitalMartin Bergman - Community Health Systems - Moses Taylor HospitalJurgen Craig-Muller - CentracareJacqueline Detert - MSB Medical School BerlinLia Georgescu - Spitalul Clinic Judetean de Urgenta Târgu MureşLaure Gossec - Hôpital CochinHisham Hamoud - Al Azhar Univ, Cairo, EgyptJohannes W. G. Jacobs - University Medical Center UtrechtIeda Maria Magalhaes Laurindo - Univ Sao Paulo, Sao Paulo, BrazilMaria Majdan - Medical University of LublinAntonio Naranjo - Hospital Universitario de Gran Canaria Doctor NegrínSapan Pandya - Care Institute of Medical SciencesChristof Pohl - MSB Medical School BerlinGeorg Schett - Friedrich-Alexander-Universität Erlangen-NürnbergZahraa I. Selim - Sohag UniversitySergio Toloza - Hosp San Juan Bautista, Catamarca, ArgentinaHisahi Yamanaka - The University of TokyoTuulikki Sokka - Central Finland Health Care District
- Publication Details
- Arthritis care & research (2010), v 64(2), pp 206-214
- Publisher
- Wiley
- Number of pages
- 9
- Grant note
- Pfizer Bristol-Myers Squibb Takeda; Takeda Pharmaceutical Company Ltd Abbott (Finland); Abbott Laboratories Merck; Merck & Company Chugai BMS; Bristol-Myers Squibb Schering-Plough; Merck & Company; Schering Plough Corporation 1UL1RR029884 / National Center for Research Resources; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Center for Research Resources (NCRR) Mundipharma
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Medicine (Graduate)
- Web of Science ID
- WOS:000299465200007
- Scopus ID
- 2-s2.0-84858010848
- Other Identifier
- 991021916904804721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Rheumatology