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Clinical Assessment vs Patient Experience in RA

Arthritis Care Res; 2018 Oct; Kvrgic, et al

Typical clinical assessments did not capture the everyday experience of patients with rheumatoid arthritis (RA), according to a recent study that sought to explore the perspectives and experiences of patients with RA whose assessments of their disease differ from those of their rheumatology care provider. A total of 20 adult patients with RA with patient‐provider discordance at their most recent rheumatology appointment (within 4 weeks) were recruited. Discordance was defined by an absolute difference of ≥25 between patient and provider global assessments on a visual analog scale (VAS) of disease activity. For descriptive purposes, participants completed the Health Assessment Questionnaire II, pain VAS, and Patient Health Questionnaire-9 depression scale. Interviews were conducted in person and individually with each patient with a semi-structured interview guide. Researchers found that 6 major themes emerged from the patient interviews describing patient‐provider discordance and disease assessment:

  • being misunderstood by others,
  • limitations of provider assessments,
  • discrepancy with provider findings,
  • inadequate active listening on the part of health care providers,
  • unmet psychosocial needs, and
  • lack of patient empowerment.

Citation:

Kvrgic Z, Asiedu GB, Crowson CS, Ridgeway JL, David III JM. “Like no one is listening to me”: A qualitative study of patient-provider discordance between global assessments of disease activity in rheumatoid arthritis. Arthritis Care Res. 2018;70(10):1439-1447. doi:10.1002/acr.23501.