Discordance of global assessment between the patients and physicians predicts 9-year pain-related outcomes in rheumatoid arthritis patients

Frontiers in Medicine

Medicine

Kenji Miki¹  Kazuhiro Hayashi²  Takao Takeuchi³  Masahiro Hayaishi³  Yasuhisa Hayaishi³  Takehiro Hirayama⁴  Kohei Tsujimoto⁴  Masao Yukioka⁵  Kenrin Shi⁶ 

[1] Center for Pain Management, Hayaishi Hospital, Osaka, Japan;Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan;Japan Pain Foundation, Tokyo, Japan;Department of Physical Therapy and Rehabilitation Science, University of Iowa, Iowa City, IA, United States;Department of Respiratory Medicine and Clinical Immunology, Graduate School of Medicine, Osaka University, Suita, Japan;Department of Rheumatology, Yukioka Hospital, Osaka, Japan;Faculty of Health Science, Osaka Yukioka College of Health Science, Ibaraki, Japan;Department of Rheumatology, Tenjin Orthopaedics and Rheumatology, Osaka, Japan;Japan Pain Foundation, Tokyo, Japan;

关键词: arthritis rheumatoid;    communication;    physicians;    prognosis;    quality of life;   

DOI  :  10.3389/fmed.2023.1189748

 received in 2023-03-20, accepted in 2023-05-26,  发布年份 2023

来源: Frontiers

【 摘 要 】

IntroductionPerspectives regarding the disease state often differ between patients with rheumatoid arthritis (RA) and physicians. The aim of the present longitudinal cohort study was to investigate the impact of the discordance in global assessments between patients and physicians on 9-year pain-related outcomes in patients with rheumatoid arthritis.MethodSixty-eight consecutive outpatients with rheumatoid arthritis on their first visit to a tertiary center were included. Baseline measurements included demographic data, drugs used, disease activity, and a modified Health Assessment Questionnaire (mHAQ). Discordance in global assessment between patients and physicians at baseline was defined as 10 mm higher in the patient global assessment (PGA) than in the physician global assessment. A 9-year follow-up assessment included pain intensity, the European Quality of Life 5 Dimensions 3 Level (EQ-5D-3L) scale, Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), Pain Disability Assessment Scale (PDAS), and Pain Self-Efficacy Questionnaire (PSEQ).ResultsThe number of patients with discordance was 26 (38%) in 68 patients. Patients with a 10 mm higher PGA than the physician global assessment at baseline measurements had significantly worse pain intensity, PCS score, PSEQ score, and EQ-5D-3L score measurements at the 9-year follow-up than those with concordance. A higher mHAQ score and 10 mm higher PGA at baseline were significantly independently associated with the EQ-5D-3L scale score and pain intensity at the 9-year follow-up.ConclusionThis longitudinal cohort study suggested that discordance in global assessment between patients and physicians modestly predicted worse 9-year pain-related outcomes in patients with rheumatoid arthritis.

【 授权许可】

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Copyright © 2023 Hayashi, Miki, Shi, Yukioka, Hirayama, Tsujimoto, Takeuchi, Hayaishi and Hayaishi.