Physician-patient alignment in satisfaction with psoriatic arthritis treatment in Latin America

Soriano, Enrique R.; Zazzetti, F.; Pereira, Ivânio Alves; Cocco, José Maldonado; Azevedo, Valderílio Feijó; Guerra, Generoso; Bautista-Molano, Wilson; Casasola, J. C.; Vega‐Morales, David; Gil, Diana Rocío; Lobosco, S.; Lawson, Fábio Lorea

doi:10.1007/s10067-019-04870-1

Cited by 14 publications

(5 citation statements)

References 42 publications

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“…General physicians' approach should encompass multiple clinical perspectives when dealing with autoimmune diseases [ 16 , 17 ]. While specialist input is invaluable, general physicians, with their broad understanding of medicine, are uniquely placed to identify overlaps and connections in disease presentations.…”

Section: Discussionmentioning

confidence: 99%

Concurrent Presentation of Pustular Psoriasis and Late-Onset Rheumatoid Arthritis: A Diagnostic Challenge in a Community Hospital Setting

Chayama,

Amano,

Ofuji

et al. 2023

Cureus

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The coexistence of autoimmune diseases presents a significant diagnostic challenge in clinical practice, particularly in settings with limited resources. This case report details a rare instance of pustular psoriasis occurring concurrently with rheumatoid arthritis, underscoring the complexities involved in diagnosing overlapping autoimmune disorders. A 70-year-old male with a history of chronic heart failure, atrial fibrillation, and other comorbidities presented to a rural community hospital with a year-long persistent rash and joint and back pain. Physical examination and blood tests revealed high inflammatory markers. A dermatological assessment, including a skin biopsy, diagnosed generalized pustular psoriasis. However, the atypical presentation of acute polyarthritis led to further investigations, revealing elevated rheumatoid factor and anti-citrullinated protein antibody levels, resulting in a diagnosis of late-onset rheumatoid arthritis. The patient underwent a comprehensive treatment regime, including prednisolone, cefazolin, oral terbinafine, methotrexate, and infliximab, leading to gradual symptom improvement to the previous activity of daily life and discharge on the 27th day of hospitalization. This case illustrates the diagnostic intricacies in identifying concurrent autoimmune disorders and highlights the crucial role of general physicians in systematically approaching complex cases in resource-limited settings. It emphasizes the need for heightened clinical vigilance and a multifaceted diagnostic approach when managing patients with overlapping rheumatic symptoms, advocating for consideration of coexisting conditions in autoimmune diseases.

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Section: Discussionmentioning

confidence: 99%

Concurrent Presentation of Pustular Psoriasis and Late-Onset Rheumatoid Arthritis: A Diagnostic Challenge in a Community Hospital Setting

Chayama,

Amano,

Ofuji

et al. 2023

Cureus

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“…Resultados similares también fueron publicados en estudios de diferentes regiones del mundo, tanto en poblaciones con AR como con APs, donde aquellos pacientes con mejores respuestas clínicas o enfermedades menos severas mostraron mayor grado de conformidad tanto del paciente como del médico tratante. [43][44][45] Esto coincide con nuestros resultados, en el cual observamos mayor conformidad con el tratamiento en los pacientes recibiendo DMEb por vía SC y en aquellos con mejor control de la actividad de su enfermedad. La mayoría de estos pacientes tuvieron preferencia por la vía SC, y esto probablemente se deba a que los pacientes tienden a preferir la misma vía de administración de la medicación con la que están conformes, porque lograron controlar la actividad de su enfermedad.…”

Section: Discussionunclassified

Treatment preferences in patients with axial spondyloarthritis

Capelusnik

Oviedo

Gutiérrez

et al. 2020

Rev. Argent. Reumatol.

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Background: One of the premises of the Treat to Target (T2T) is the shared treatment decision between the rheumatologist and the patient. For this reason, patient preferences play a fundamental role in the success of treatment in the short and long term. The aims of this study were to evaluate the treatment preferences of patients with Axial Spondyloarthritis (axSpA) and to identify the factors associated with their choice. Material and methods: Cross sectional study. Patients ≥18 years old that fulfilled the ASAS 2009 criteria for axSpA were included. Sociodemographic data, comorbidities, disease characteristics, and treatments received were recorded. A specially designed questionnaire in both, multiple choice modality and response mode listed in order of priority of the statements was administered. Statistical analysis: Descriptive statistics. Student’s T-test, Chi2 test and multiple logistic regression analysis. A value of p <0.05 was considered significant. Results: Seventy patients were included with a median age (m) of 46.5 years (IQR: 38-57), 55 males (78.6%) and a median disease duration of 13.5 years (IQR: 7.75-23.25). The relevant aspects for choosing a treatment were: the ability to improve the quality of life (32.9%), followed by improvement in joint inflammation (22.9%), pain (21. 4%) and physical function (14.3%). The chosen administration routes in decreasing order of frequency were: oral (51.4%), subcutaneous (SC) (41.4%), intramuscular (IM) 4.3% and intravenous (IV) 2.9%. The preferred frequency of oral administration was one tablet per week (61.1%) and SC administration, once a month (34.5%). The choice of oral route was associated with: preference for self-administration, preference for receiving the medication at home and higher level of education. The choice of the SC route was independently associated with the type of axSpA (AS) and a lower educational level. The patients under biological SC treatment and with lower disease activity, showed higher level of treatment satisfaction. Conclusion: The most preferred way of administration by patients with axSpA was the oral route. Lower disease activity and SC biological treatment were associated with treatment greater compliance.

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“…The lack of experience with PsA among primary care physicians impinges on the diagnosis and management of PsA in primary care. Although the diagnostic approach for PsA is based on clinical expertise, physical examination, and imaging techniques [ 14 ], many primary care professionals may need to gain experience with the disease [ 23 ]. Challenges faced by GPs in interpreting symptoms, especially when blood tests are normal, point to the complexities of the clinical picture of PsA [ 15 ].…”

Section: Reviewmentioning

confidence: 99%

Challenges in Diagnosing Psoriatic Arthritis in Primary Care: A Meta-Ethnographic Study

Ohta,

Sano

2023

Cureus

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Psoriatic arthritis (PsA) is a complex and debilitating chronic inflammatory joint disorder that is often associated with psoriasis and presents significant challenges in its early diagnosis and management. Therefore, this study aimed to investigate the diagnostic intricacies of PsA in primary care settings to shed light on the prevalence, barriers, and implications of delayed diagnosis. To achieve our research objectives, we conducted a qualitative synthesis using the meta-ethnographic method, which is a robust approach for synthesizing qualitative data. We systematically searched the PubMed, Web of Science, and Embase databases for relevant articles using predefined search terms such as "psoriatic arthritis," "diagnosis," and "primary care." The inclusion criteria were narrative articles in English that provided insights into the diagnostic challenges of PsA in primary care. Conference presentations, original articles, and duplicate articles were excluded. Our analysis revealed four key themes that elucidated the multifaceted nature of PsA diagnosis in primary care: (1) a variety of initial and non-specific symptoms, highlighting the diverse clinical presentations that can mimic other conditions; (2) the lack of experience with PsA among primary care professionals, underscoring the importance of education and training; (3) the lack of skin lesions, which can complicate diagnosis when not present; and (4) a delay in diagnosis, with potentially severe consequences for patients' health and quality of life. This study highlights the challenges inherent in the diagnosis of PsA in primary care settings. The multifaceted nature of the disease, coupled with limited experience among primary care providers, often results in delayed diagnosis and subsequent treatment initiation. Early recognition and intervention are pivotal for optimizing patient outcomes. Addressing these challenges necessitates a comprehensive approach involving heightened clinical suspicion, continuous medical education, interdisciplinary collaboration, and utilization of standardized diagnostic criteria. Collaboration between primary care physicians and specialists is crucial for enhancing the accuracy and timeliness of PsA diagnosis and ultimately improving patient well-being and quality of life.

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Physician-patient alignment in satisfaction with psoriatic arthritis treatment in Latin America

Cited by 14 publications

References 42 publications

Concurrent Presentation of Pustular Psoriasis and Late-Onset Rheumatoid Arthritis: A Diagnostic Challenge in a Community Hospital Setting

Concurrent Presentation of Pustular Psoriasis and Late-Onset Rheumatoid Arthritis: A Diagnostic Challenge in a Community Hospital Setting

Treatment preferences in patients with axial spondyloarthritis

Challenges in Diagnosing Psoriatic Arthritis in Primary Care: A Meta-Ethnographic Study

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