Clinicians underestimate disease burden in their OA patients

Rheumatologists are twice as likely to underestimate the severity of disease in their patients with OA compared to their RA patients.

Speaking at #EULAR2016 here in London, Dr Isabel Castrejon from the Rush University Medical Centre in Chicago said addressing discordance between physician and patient perception of disease was important because of the negative impact it could have on the best choice of therapy.

“This in turn is likely to interfere with treatment compliance and future outcomes,” she said.

Dr Castrejon and colleagues found the rating of disease severity by the patient with OA was >2 units greater than physician assessment in one third of 243 OA patients compared to one fifth of the 216 RA patients involved in the study.

A higher percentage of patients with RA were in agreement with their physician about their disease severity compared to those with OA (67% vs 57%).

Having higher pain was a significant predictor of discordance for both groups of patients.

“Rheumatologists need to revise their generally held views that OA is less severe than RA,” Professor Castrejon said.

“Sometimes we feel that [OA] patients are not in concordance with us because we are not doing enough,” she said.

This was in contrast to managing RA, where clinicians felt they could treat the disease by reducing inflammation.

“We don’t have treat-to-target in OA…It’s important that we have conversations with our patients with OA, exercise and weight loss can help can help…there are more things we can do,” she said.

Physician and patient evaluation of disease severity were both based on a 0-10 visual analogue scale patient assessment included completion of a multidimensional health assessment questionnaire, with scores for physical function, pain and fatigue, a symptom checklist, and a self-reported joint count.

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