RT Journal Article
SR Electronic
T1 Discordance of Global Assessments by Patient and Physician Is Higher in Female than in Male Patients Regardless of the Physician’s Sex: Data on Patients with Rheumatoid Arthritis, Axial Spondyloarthritis, and Psoriatic Arthritis from the DANBIO Registry
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP 1781
OP 1785
DO 10.3899/jrheum.150007
VO 42
IS 10
A1 Cecilie Lindström Egholm
A1 Niels Steen Krogh
A1 Theodore Pincus
A1 Lene Dreyer
A1 Torkell Ellingsen
A1 Bente Glintborg
A1 Marcin Ryszard Kowalski
A1 Tove Lorenzen
A1 Ole Rintek Madsen
A1 Henrik Nordin
A1 Claus Rasmussen
A1 Merete Lund Hetland
YR 2015
UL http://www.jrheum.org/content/42/10/1781.abstract
AB Objective. To assess the frequency of discordance in patient’s (PtGA) and physician’s (PGA) global assessment, and to investigate whether higher discordance in female patients compared with male patients is associated with the physician’s sex in patients with rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA).Methods. PtGA, PGA, and other patient-related variables were retrieved from the Danish DANBIO registry, used nationwide to monitor patients with RA, axSpA, and PsA. A questionnaire was sent to all physicians registering in DANBIO (n = 265) regarding individual physician characteristics including sex and age. Discordance was defined as PtGA > 20 mm higher (or lower) than PGA. First encounters between patients and physicians were analyzed using descriptive statistics and mixed model regression analysis.Results. Ninety physicians (34%) returned the questionnaire and were pairwise matched with 10,282 first patient encounters (8300 patients with RA, 524 axSpA, and 1458 PsA). The frequency of discordant (PtGA > PGA) encounters (not including PGA > PtGA seen in < 2%) in RA, axSpA, and PsA was 49.0%, 48.3%, and 56.5%, respectively. Discordance was more common in female patients with high scores on functional disability, pain, and fatigue across the 3 diseases, whereas it was independent of the physician’s sex.Conclusion. In this study on Danish patients with RA, axSpA, and PsA, the PtGA was > 20 mm higher than the PGA in about half of the encounters, and more common in female patients of both female and male physicians. This finding highlights one of the challenges in shared decision making.