Abbas Noura, Hmamouchi Ihsane, Kibbi Lina El, Maroof Avin, Elzorkany Bassel, Abdulateef Nizar, Adnan Asal, Ihsan Nabaa, Gorial Faiq Isho, Al Chama Nada, Haouichat Chafika, Alnaimat Fatima, Hannawi Suad, Atawnah Saed, Halabi Hussein, Al Mashaleh Manal, Aljazwi Laila, Abogamal Ahmed, Ayoub Laila, Bouajina Elyes, Bahiri Rachid, Saad Sahar, Sabkar Maha, Aouad Krystel, Ziadé Nelly, Gossec Laure
Saint-Joseph University and Hotel-Dieu de France Hospital, Beirut, Lebanon.
Faculty of Medicine, International University of Rabat (UIR), Health Sciences Research Center (CReSS), Rabat, Morocco.
Rheumatol Int. 2025 Mar 12;45(4):70. doi: 10.1007/s00296-025-05819-1.
Discordance between physicians and patients in assessing psoriatic arthritis (PsA) activity is common and might impact treatment adherence and decision-making. Cultural and belief systems may influence this discordance. This study aimed to assess the extent of patient-physician discordance in PsA in Arab countries and its association with demographic and disease characteristics.The TACTIC study was a cross-sectional observational study across 13 Arab countries in 2022. Patient and physician global assessments (PGA, PhGA) of disease activity (0-10 scale) were collected, along with demographic and disease data, Disease Activity in Psoriatic Arthritis (DAPSA), and Psoriatic Arthritis Impact of Disease (PsAID). Discordance was defined as an absolute difference of |PGA-PhGA|> 2. Its association with patient characteristics was analyzed through multivariable multinomial logistic regression. In 538 patients (317 females, 58.9%), with a mean age of 45.5 ± 13.2 years and PsA duration of 8.8 ± 7.3 years, the disease was moderately active (mean DAPSA 19.3 ± 16.1; mean PsAID 3.86 ± 2.33). Mean PGA was higher than mean PhGA (4.7 ± 2.5 versus 4.0 ± 2.4, p < 0.001) with an absolute difference of 1.30 ± 1.41 and a high correlation between global assessments (r = 0.74). Discordance was infrequent, occurring in 84 patients (15.6%), and was mostly due to higher PGA (70/84, 83.3%). Discordance (one-point increase) was associated with a lower PhGA (Odds ratio (OR) 3.03 [95%CI 2.18-4.22]), positive fibromyalgia screening (OR 1.28 [95%CI 1.03-1.58]), higher DAPSA (OR 1.16 [95%CI 1.03-1.09]), and higher PsAID scores (OR 2.63 [95%CI 1.96-3.54]). Discordance was primarily identified in patients with moderate disease activity. Discordance between PGA and PhGA was infrequent in Arab countries, suggesting strong patient-physician alignment. Expectations and disease perceptions may play a role in this discordance.
在评估银屑病关节炎（PsA）活动方面，医生与患者之间存在不一致是常见现象，这可能会影响治疗依从性和决策。文化和信仰体系可能会影响这种不一致。本研究旨在评估阿拉伯国家PsA患者与医生之间不一致的程度及其与人口统计学和疾病特征的关联。TACTIC研究是一项于2022年在13个阿拉伯国家开展的横断面观察性研究。收集了患者和医生对疾病活动度（0 - 10分制）的整体评估（PGA、PhGA），以及人口统计学和疾病数据、银屑病关节炎疾病活动度（DAPSA）和银屑病关节炎疾病影响（PsAID）。不一致被定义为|PGA - PhGA|> 2的绝对差值。通过多变量多项逻辑回归分析其与患者特征的关联。在538例患者（317例女性，58.9%）中，平均年龄为45.5±13.2岁，PsA病程为8.8±7.3年，疾病处于中度活动期（平均DAPSA为19.3±16.1；平均PsAID为3.86±2.33）。平均PGA高于平均PhGA（4.7±2.5对4.0±2.4，p < 0.001），绝对差值为1.30±1.41，且整体评估之间具有高度相关性（r = 0.74）。不一致情况不常见，发生在84例患者（15.6%）中，且主要是由于PGA较高（70/84，83.3%）。不一致（增加一分）与较低的PhGA（比值比（OR）3.03 [95%置信区间2.18 - 4.22]）、纤维肌痛筛查阳性（OR 1.28 [95%置信区间1.03 - 1.58]）、较高的DAPSA（OR 1.16 [95%置信区间1.03 - 1.09]）以及较高 的PsAID评分（OR 2.63 [95%置信区间1.96 - 3.54]）相关。不一致主要在疾病活动度为中度的患者中被发现。在阿拉伯国家，PGA和PhGA之间的不一致情况不常见，这表明患者与医生之间的一致性较强。期望和疾病认知可能在这种不一致中起作用。
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