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Rheumatologists more likely to underestimate impact of osteoarthritis than rheumatoid arthritis

Roshini Claire Anthony
13 Jun 2016

Despite having a higher burden of disease, individuals with osteoarthritis (OA) are more likely to have their condition underestimated by rheumatologists than individuals with rheumatoid arthritis (RA), according to a study presented at the European League Against Rheumatism Annual Congress (EULAR 2016) held in London, UK.

To analyse the discordance between physician global estimates (DOCGL) and patient global estimates (PATGL) in patients with RA (n=216) or OA (n=243), patients were asked to complete a multidimensional health assessment questionnaire/routine assessment of patient index data (MDHAQ/RAPID3) while physicians used the RheuMetric checklist, both of which enabled evaluation of disease severity on a visual analogue scale (VAS). [EULAR 2016, abstract OP0094]

Patients with RA were more likely to be in concordance with their physicians (67 percent, n=144) compared to OA patients (56 percent; n=136).

Patient perception of disease severity exceeded that of physician perception (PATGL>DOCGL) in 82 OA patients (34 percent) and 39 (18 percent) RA patients, while physician perception was higher than patient perception of disease severity (DOCGL>PATGL) in 33 RA (15 percent) and 25 OA patients (10 percent).

There was an almost two-fold greater likelihood that rheumatologists would underrate OA compared to RA, said study author Dr. Isabel Castrejón from the Rush University Medical Center, Chicago, Illinois, US who presented the results.

Dr. Isabel Castrejón

In both diagnosis groups, higher perception of disease severity was more likely in patients with lower education levels, higher levels of pain, disability, fatigue, and joint counts, and more symptoms. Experiencing higher levels of pain was found to be a significant predictor of discordance for both diagnosis groups, said Castrejón.

Previous studies have pointed to discordance between patient and physician assessment of rheumatic disease severity. [Arthritis Care Res (Hoboken) 2014;66:934-942; Arthritis Care Res (Hoboken) 2012;64:206-214]

“Concordance by patients and physicians has been associated with greater expectations for improvement and better outcomes. It is important to be able to recognize discordance by patients and physicians because that can influence treatment adherence, compliance, and future outcomes,” said Castrejón.

“RA is generally thought to be more severe than OA, not only by physicians but also by patients and the public,” said Castrejón. “Rheumatologists need to revise their generally held views that OA is less severe than RA,” she said, while stressing on the importance of good communication between patients and physicians.
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Most Read Articles
01 Nov 2013

Joint stiffness is defined as discomfort after a period of inactivity. It is associated with reduced or loss of range of motion in a joint.

01 Aug 2016
Etoricoxib exhibits a central mode of action and enhances pain and function in patients with painful knew osteoarthritis (OA), as presented in a randomised, double-blind, placebo-controlled, two-way crossover, four-week treatment study.
Stephen Padilla, 25 Nov 2016
The addition of supervised physiotherapy to usual care does not provide clinically important improvement in the management of simple ankle sprains in a general population of patients seeking hospital-based acute care, according to results of a recent randomized controlled trial.
24 Jul 2017
The toxic side-effects of chemotherapy appear to be induced by cell-free chromatin (cfCh) fragments released from dying cells, triggering DNA damage, apoptosis and inflammation in healthy cells, thereby exaggerating or amplifying the toxic effects caused by the drugs themselves, according to a study.