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A cross‐sectional study on factors associated with patient–physician discordance in global assessment of patients with axial spondyloarthritis: an Asian perspective
Author(s) -
Wang Charmaine Tze May,
Fong Warren,
Kwan Yu Heng,
Phang Jie Kie,
Lui Nai Lee,
Leung Ying Ying,
Thumboo Julian,
Cheung Peter P.
Publication year - 2018
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13299
Subject(s) - medicine , ankylosing spondylitis , cross sectional study , univariate analysis , physical therapy , multivariate analysis , population , pathology , environmental health
Aim To identify the factors associated with patient–physician discordance in patients with axial spondyloarthritis (axSpA) in an Asian population. Methods A cross‐sectional study was conducted in two tertiary referral centers in Singapore. Patients with axSpA who fulfilled Assessment in Ankylosing Spondylitis International Working Group 2009 criteria for axSpA were included in the study. Socio‐demographics, clinical, laboratory and patient‐reported outcomes data were collected during study visits from 2014 to 2015. We performed univariate and multivariate linear regression analyses to evaluate the factors associated with patient–physician discordance, which we defined as the difference between Patient Global Assessment and Physician Global Assessment. Results Included in the study were 298 axSpA patients: 82% male, 81% Chinese, median age 40 (20–78) years, median disease duration 9 (0.1–48) years. 80% were on non‐steroidal anti‐inflammatory drugs and 23% on biologics. In univariate analysis, current age (β: 0.18, ρ = 0.06), duration of disease (β: 0.34, ρ = 0.03), post‐secondary education level (β: −10.82, ρ = 0.03), global pain score (β: 0.33, ρ < 0.01), Bath Ankylosing Spondylitis Functional Index (β: 2.80, ρ < 0.01), Ankylosing Spondylitis Disease Activity Score C‐reactive protein (β: 4.63, ρ < 0.01) and current use of biologics (β: 10.97, ρ < 0.01) were associated with patient–physician discordance. In multivariate analysis, global pain score (β: 0.32, ρ < 0.01), post‐secondary education level (β: −12.80, ρ = 0.01) and current biologics use (β: 16.21, ρ < 0.01) were associated with patient–physician discordance. Conclusion Higher global pain score, lower educational level and current biologics use were associated with greater patient–physician discordance. These factors should be considered during shared decision making.