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<p>Discordance between physicians and patients in assessing psoriatic arthritis (PsA) activity is common and might impact treatment adherence and decision-making. Cultural and belief systems may influence this discordance. This study aimed to assess the extent of patient-physician discordance in PsA in Arab countries and its association with demographic and disease characteristics.The TACTIC study was a cross-sectional observational study across 13 Arab countries in 2022. Patient and physician global assessments (PGA, PhGA) of disease activity (0–10 scale) were collected, along with demographic and disease data, Disease Activity in Psoriatic Arthritis (DAPSA), and Psoriatic Arthritis Impact of Disease (PsAID). Discordance was defined as an absolute difference of |PGA-PhGA|&gt; 2. Its association with patient characteristics was analyzed through multivariable multinomial logistic regression. In 538 patients (317 females, 58.9%), with a mean age of 45.5 ± 13.2&#xa0;years and PsA duration of&#xa0;8.8 ± 7.3&#xa0;years, the disease was moderately active (mean DAPSA 19.3 ± 16.1; mean PsAID 3.86 ± 2.33). Mean PGA was higher than mean PhGA (4.7 ± 2.5 versus 4.0 ± 2.4, <i>p</i> &lt; 0.001) with an absolute difference of 1.30 ± 1.41 and a high correlation between global assessments (<i>r</i> = 0.74). Discordance was infrequent, occurring in 84 patients (15.6%), and was mostly due to higher PGA (70/84, 83.3%). Discordance (one-point increase) was associated with a lower PhGA (Odds ratio (OR) 3.03 [95%CI 2.18–4.22]), positive fibromyalgia screening (OR 1.28 [95%CI 1.03–1.58]), higher DAPSA (OR 1.16 [95%CI 1.03–1.09]), and higher PsAID scores (OR 2.63 [95%CI 1.96–3.54]). Discordance was primarily identified in patients with moderate disease activity. Discordance between PGA and PhGA was infrequent in Arab countries, suggesting strong patient-physician alignment. Expectations and disease perceptions may play a role in this discordance.</p>

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Discordance between patient and physician global assessments of psoriatic arthritis activity: an observational study in 13 Arab countries

  • 期刊论文

  • 发表日期：

    2025年3月12日

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  • Noura Abbas,
  • Ihsane Hmamouchi,
  • Lina El Kibbi,
  • Avin Maroof,
  • Bassel Elzorkany,
  • Nizar Abdulateef,
  • Asal Adnan,
  • Nabaa Ihsan,
  • Faiq Isho Gorial,
  • Nada Al Chama,
  • Chafika Haouichat,
  • Fatima Alnaimat,
  • Suad Hannawi,
  • Saed Atawnah,
  • Hussein Halabi,
  • Manal Al Mashaleh,
  • Laila Aljazwi,
  • Ahmed Abogamal,
  • Laila Ayoub,
  • Elyes Bouajina,
  • Rachid Bahiri,
  • Sahar Saad,
  • Maha Sabkar,
  • Krystel Aouad,
  • Nelly Ziadé,
  • Laure Gossec

摘要

Discordance between physicians and patients in assessing psoriatic arthritis (PsA) activity is common and might impact treatment adherence and decision-making. Cultural and belief systems may influence this discordance. This study aimed to assess the extent of patient-physician discordance in PsA in Arab countries and its association with demographic and disease characteristics.The TACTIC study was a cross-sectional observational study across 13 Arab countries in 2022. Patient and physician global assessments (PGA, PhGA) of disease activity (0–10 scale) were collected, along with demographic and disease data, Disease Activity in Psoriatic Arthritis (DAPSA), and Psoriatic Arthritis Impact of Disease (PsAID). Discordance was defined as an absolute difference of |PGA-PhGA|> 2. Its association with patient characteristics was analyzed through multivariable multinomial logistic regression. In 538 patients (317 females, 58.9%), with a mean age of 45.5 ± 13.2 years and PsA duration of 8.8 ± 7.3 years, the disease was moderately active (mean DAPSA 19.3 ± 16.1; mean PsAID 3.86 ± 2.33). Mean PGA was higher than mean PhGA (4.7 ± 2.5 versus 4.0 ± 2.4, p < 0.001) with an absolute difference of 1.30 ± 1.41 and a high correlation between global assessments (r = 0.74). Discordance was infrequent, occurring in 84 patients (15.6%), and was mostly due to higher PGA (70/84, 83.3%). Discordance (one-point increase) was associated with a lower PhGA (Odds ratio (OR) 3.03 [95%CI 2.18–4.22]), positive fibromyalgia screening (OR 1.28 [95%CI 1.03–1.58]), higher DAPSA (OR 1.16 [95%CI 1.03–1.09]), and higher PsAID scores (OR 2.63 [95%CI 1.96–3.54]). Discordance was primarily identified in patients with moderate disease activity. Discordance between PGA and PhGA was infrequent in Arab countries, suggesting strong patient-physician alignment. Expectations and disease perceptions may play a role in this discordance.