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

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Abstract

Introduction

Physician-patient misalignment may exist in real-life clinical practice. We aimed to assess physician and patient treatment satisfaction levels and associated degree of misalignment in psoriatic arthritis (PsA).

Method

Data from a cross-sectional survey of patients and their physicians conducted in Latin America were analyzed. Physician-reported and patient-reported satisfaction levels with current PsA treatment, alignment in satisfaction levels, and factors associated with satisfaction misalignment were assessed through bivariable and multivariable regression analyses.

Results

A total of 179 physician-patient pairs were analyzed. Physicians reported satisfaction with current disease control in 87.7% (n = 157) of cases; patients reported satisfaction in 91.1% (n = 163 of cases). A total of 82.1% of physician-patient pairs were aligned. Compared with aligned patients, misaligned patients were older and more likely to have moderate or severe disease, deteriorating or unstable disease, a past hospital procedure, current or past psoriasis symptoms, greater current pain, a current acute episode, poorer health and quality of life, greater impairment, poorer medication compliance, to consider PsA a major daily burden, and to believe that PsA treatments were ineffective. Misaligned patients were less likely to be in remission. Logistic regression analysis revealed that misaligned patients were older, and more likely to consider PsA a major daily burden and PsA treatments as ineffective.

Conclusions

High levels of treatment satisfaction and alignment were observed among PsA patients and their physicians in Latin America. Patients in this study nevertheless experienced a considerable clinical and quality-of-life burden, especially the misaligned patients. Addressing misalignment may lead to improved PsA disease control.

Key points

• High treatment satisfaction was observed among PsA patients and their treating physicians in Latin America.

• Patients experienced a considerable clinical and quality-of-life burden, especially the misaligned patients.

• One-fifth of physician-patient pairs were misaligned regarding satisfaction.

• Understanding and addressing misalignment may improve outcomes in this patient population.

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Acknowledgments

The authors would like to thank all patients and physicians who took part in the survey. Derek Ho, PhD, and Elizabeth A. Holdsworth provided medical writing support in the development of this manuscript. Olivia Massey provided statistical expertise.

Author information

Authors and Affiliations

  1. Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    Enrique Roberto Soriano

  2. Janssen Cilag Farmacéutica S.A, Buenos Aires, Argentina

    Federico Zazzetti

  3. Universidade Federal de Santa Catarina, Hospital Universitário, Divisão de Reumatologia, Florianópolis, SC, Brazil

    Ivanio Alves Pereira

  4. School of Medicine, Buenos Aires University, Buenos Aires, Argentina

    José Maldonado Cocco

  5. Federal University of Paraná, Curitiba, PR, Brazil

    Valderilio Feijó Azevedo

  6. Centro Médico Royal Center Paitilla, Internal Medicine and Rheumatology, Panamá, Panama

    Generoso Guerra

  7. Rheumatology Section, University Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia

    Wilson Bautista-Molano

  8. Servicio de Reumatologia del Hospital General de México, Ciudad de México, Mexico

    Julio César Casasola

  9. Universidad Autónoma de Nuevo León, Rheumatology Service, Monterrey, Mexico

    David Vega Morales

  10. ART Medica - Hospital Universitario Mayor MEDERI, Internal Medicine and Rheumatology, Bogotá, Colombia

    Diana Rocío Gil

  11. Adelphi Real World, Bollington, UK

    Steve Lobosco

  12. Janssen Cilag Farmacéutica, São Paulo, Brazil

    Fabio Lawson

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  1. Enrique Roberto Soriano
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  2. Federico Zazzetti
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Corresponding author

Correspondence to Steve Lobosco.

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Conflict of interest

All authors have access to the primary data and agree the journal can review data if requested. FZ and FL are employees of Janssen, who sponsored this research. SL is an employee of Adelphi Real World, who received funding from Janssen for this research. Other authors do not have a financial relationship with Janssen. A further and complete list of financial and non-financial disclosures for all authors follows: ES participated as Advisory board member, speaker or received grant support from AbbVie, Amgen, Bristol-Myers Squibb, GSK, Genzyme, Janssen, Lilly, Novartis, Pfizer, Roche, Sandoz, Sanofi, and UCB; IAP participated as Advisory board member from Novartis, Pfizer, and Janssen, and speaker to Janssen, Abbvie, Lilly, Roche, Pfizer, and Novartis; JMC received consulting fees and/or participated in Speakers’ Bureau for Pfizer, Merck Sharp and Dohme, Sanofi–Aventis, Genzyme, Novartis, Bristol-Myers Squibb, Roche, Boehringer-Ingelheim, Schering–Plough, Abbott, UCB, Eli Lilly, and Gilead; VFA received research funds from Abbvie, GSK, Janssen, Pfizer, BMS, Lilly, Boehringer-Ingelheim, Genentech, and UCB, participated as Advisory board member from Sandoz, Novartis, Lilly, Pfizer, Boehringer-Ingelheim, and Janssen, and speaker to Boehringer-Ingelheim, Janssen, Abbvie, Lilly, Celltrion, Pfizer, and Novartis; GG has no further conflicts of interest to disclose; WBM participated as speaker from Bristol-Myers Squibb, Janssen, Lilly, Novartis, and Pfizer; JCC participated as speaker from Abbvie, UCB, Jannsen, Pfzier, Novartis, Roche, and Celgene, and as Advisory board member from UCB, Jannsen, and Novartis; DVM participated as Advisory board member, speaker, or received grant support from Abbvie, Roche, UCB, and Pfizer; DRG participated as Advisory board member from Janssen and Lilly, and speaker from AbbVie, Amgen, Bristol-Myers Squibb, Janssen, Pfizer, and Roche; SL is an employee of Adelphi Real World and has no further conflicts of interest to disclose; FZ and FL are employees of Janssen and have no further conflicts of interest to disclose.

Ethical standards

All participating patients provided informed consent for use of their anonymized and aggregated data for research and publication in scientific journals. Data collection was performed such that patients and physicians could not be identified directly, and all data were aggregated and de-identified before receipt. Data collection was performed in accordance with the European Pharmaceutical Marketing Research Association guidelines; ethics committee approval was thus not required. Each survey was performed in full accordance with relevant legislation at the time of data collection, including the US Health Insurance Portability and Accountability Act 1996 [34] and Health Information Technology for Economic and Clinical Health Act legislation [35].

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Soriano, E.R., Zazzetti, F., Alves Pereira, I. et al. Physician-patient alignment in satisfaction with psoriatic arthritis treatment in Latin America. Clin Rheumatol 39, 1859–1869 (2020). https://doi.org/10.1007/s10067-019-04870-1

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