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Patient-Physician Assessments and Quality of Life

RMD Open; ePub 2017 Oct 25; Karpouzas, et al

Determinants of patient and physician global assessments (PtGA and MDGA, respectively) and changes over 2 years were disparate in Hispanics with rheumatoid arthritis (RA), yielding significant discordance, a recent study found. Higher patient ratings at any time contributed to worse health-related quality of life (HRQOL), work productivity, and activity impairment on final visit. Researchers studied 536 Hispanics with established RA from a single center. PtGA and MDGA were measured annually on 10 cm visual analogue scales and discordance was defined as absolute difference between them ≥3 cm. They found:

  • Independent predictors of baseline PtGA were pain, fatigue, depression, general health perceptions, and tender joint count.
  • MDGA was predicted by swollen joint count, tender joint count, erythrocyte sedimentation rate, fatigue, and depression.
  • Both PtGA and MDGA improved over time.
  • Discordance was observed in 43% at baseline, with fair stability over 2 years.
  • Higher (worse) patient ratings were most prevalent; their presence at any time and increasing persistence predicted lower physical and mental HRQOL, decreased work productivity and more activity impairment at 2-year follow-up.

Citation:

Karpouzas GA, Ramadan SN, Cost CE, et al. Discordant patient–physician assessments of disease activity and its persistence adversely impact quality of life and work productivity in US Hispanics with rheumatoid arthritis. [Published online ahead of print October 25, 2017]. RMD Open. doi:10.1136/rmdopen-2017-000551.

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