RESEARCH - RA patients and physicians differ on disease severity assessment

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RA Patients and Doctors Differ on Disease Severity Assessment

By Wiley

May 25, 2010 - 9:21:13 AM

(HealthNewsDigest.com) - A novel study by researchers at the

University of California, San Francisco found that nearly one-third of

Rheumatoid Arthritis (RA) patients differed from their physicians in

assessment of their disease severity. The disagreement between patient

and doctor evaluation of RA activity was most prevalent in patients

with depressive symptoms, and those who had poor overall function.

Details of the study, the first to examine discordance in an

ethnically diverse population, are published in the June issue of

Arthritis Care & Research, a journal of the American College of

Rheumatology.

According to a 2003 report from the World Health Organization (WHO)

the prevalence of RA, an autoimmune disease characterized by painful

swelling of the lining of the joints, varies between 0.3% and 1%. In

the U.S. experts estimate roughly 1 to 2 million Americans have RA

which affects twice as many women than men.

While clinicians who treat patients with diseases such as diabetes or

hypertension have a gold standard diagnostic (glucose blood test or

blood pressure) to accurately measure disease activity,

rheumatologists rely on subjective (patient self-report) and objective

measures (physician-assessed joint counts, acute-phase reactants) to

determine RA disease activity. An accurate assessment of RA activity

is essential in determining the severity of disease, monitoring

response to treatment, and is particularly important with the advent

of effective, but potentially toxic therapies. Clear patient-physician

communication around symptom reporting and assessment of disease

activity is central to the management of RA. While prior studies have

documented discordance in RA, none have examined the possible

association of patient language or mood with discordance, both of

which pose barriers to communication.

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