Determinants of patient and physician global assessments (PtGA and MDGA, respectively) and changes over 2 years were disparate in Hispanics with rheumatoid arthritis (RA), yielding significant discordance, a recent study found. Higher patient ratings at any time contributed to worse health-related quality of life (HRQOL), work productivity, and activity impairment on final visit. Researchers studied 536 Hispanics with established RA from a single center. PtGA and MDGA were measured annually on 10 cm visual analogue scales and discordance was defined as absolute difference between them ≥3 cm. They found:

• Independent predictors of baseline PtGA were pain, fatigue, depression, general health perceptions, and tender joint count.
• MDGA was predicted by swollen joint count, tender joint count, erythrocyte sedimentation rate, fatigue, and depression.
• Both PtGA and MDGA improved over time.
• Discordance was observed in 43% at baseline, with fair stability over 2 years.
• Higher (worse) patient ratings were most prevalent; their presence at any time and increasing persistence predicted lower physical and mental HRQOL, decreased work productivity and more activity impairment at 2-year follow-up.