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Study finds disagreement between RA patients and doctors on assessment of disease severity

March 19, 2017

Researchers gathered clinical data on each subject including rheumatoid factor, sedimentation rate, and tender and swollen joint counts, as well as the patient global assessment of disease severity as measured on a visual analog scale at each visit. Functional status was measured using the Health Assessment Questionnaire (HAQ). The 9-item Patient Health Questionnaire was used to measure depressive symptoms.

"We found clinically meaningful differences between patient and physician assessments of RA disease severity in 36% of cases," confirmed Dr. Barton. "In an overwhelming majority (85%) of these discordant pairs, the physicians' assessments underscored the patients' assessments." Researchers found that the mean VAS score for global disease severity was 46 ? 26 mm for patients and 31 ? 21 mm for physicians.

The research team also found that depressive symptoms were common with 30% of participants exhibiting major depression, and these patients had greater odds of discordance with their physicians than those who were not depressed. Researchers noted a lower level of patient-doctor discordance in those patients who had a higher swollen joint count, but discordance persisted in those patients with poorer functional status (HAQ score). "Reducing patient-doctor discordance is an important goal that can improve patient outcomes," concluded Dr. Barton. "Further investigation of the relationships between mood, disease activity, and discordance may help guide interventions that improve RA patient care."

SOURCE University of California