Allenzara Astia, Bush Kathleen, Husni M Elaine, Reddy Soumya M, Scher Jose U, Craig Ethan, Koplin Joelle, Walsh Jessica A, Ogdie Alexis
University of North Carolina at Chapel Hill.
University of Pennsylvania, Philadelphia.
Arthritis Care Res (Hoboken). 2025 Mar 23;77(8):1007-13. doi: 10.1002/acr.25527.
The aim of this study was to examine patient-reported treatment goals among individuals with psoriatic arthritis.
Participants in the Psoriatic Arthritis Research Consortium completed standardized assessments, including patient-reported outcome (PROs) instruments, between 2017 and 2020. Additionally, participants were asked two open-ended questions at enrollment or therapy initiation to identify patients' top improvement priority and their treatment impact goals, respectively: "If you could improve one thing about your disease, what would it be?" and "What would an effective treatment change for you?" We categorized each response into a theme. The themes were matched to constructs measured by PRO items (ie, pain, fatigue, skin, etc). We describe themes and scores from matched PRO items.
Assessments were completed by 193 participants. Decreasing pain (56%) and improving skin (12%) were the most common improvement priorities. Impact goals were more diverse and included decreasing pain (24%), general improvement in life (18%), and the ability to be more active (15%), participate in recreational activities (9%), function at work (11%), and exercise (5%). Of note, responses were often matched to more than one PRO item or instrument. The scores for PRO items that matched the patient's improvement priority or the impact goal were higher than scores for the remainder of the population (ie, fatigue item scores were higher among individuals identifying fatigue as their improvement priority).
The heterogeneity of treatment goals underscores the importance of eliciting patient treatment goals to guide personalized management. Specific items within PROs may be helpful in identifying and following patient-specific treatment goals.
本研究旨在调查银屑病关节炎患者报告的治疗目标。
银屑病关节炎研究联盟的参与者在2017年至2020年间完成了标准化评估,包括患者报告结局(PROs)工具。此外,参与者在入组或开始治疗时被问及两个开放式问题,分别以确定患者最优先改善的方面及其治疗影响目标:“如果你能改善疾病的一个方面,会是什么?”以及“有效的治疗对你来说会有什么改变?”我们将每个回答归类为一个主题。这些主题与PRO项目(即疼痛、疲劳、皮肤等)所测量的结构相匹配。我们描述了匹配的PRO项目的主题和分数。
193名参与者完成了评估。减轻疼痛(56%)和改善皮肤(12%)是最常见的优先改善方面。影响目标则更为多样,包括减轻疼痛(24%)、生活总体改善(18%)、更活跃的能力(15%)、参与娱乐活动(9%)、工作能力(11%)和锻炼(5%)。值得注意的是,回答往往与不止一个PRO项目或工具相匹配。与患者的改善优先方面或影响目标相匹配的PRO项目的分数高于其余人群的分数(即,将疲劳确定为改善优先方面的个体中,疲劳项目分数更高)。
治疗目标的异质性强调了引出患者治疗目标以指导个性化管理的重要性。PROs中的特定项目可能有助于识别和跟踪患者特定的治疗目标。