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Journal Articles Rheumatology Year : 2023

An international multicentre analysis of current prescribing practices and shared decision-making in psoriatic arthritis

Lily Watson
Conor Coyle
Caroline Whately-Smith
  • Function : Author
Melanie Brooke
  • Function : Author
Uta Kiltz
Ennio Lubrano
Rubén Queiro
David Trigos
  • Function : Author
Jan Brandt-Juergens
  • Function : Author
Ernest Choy
Salvatore D’angelo
  • Function : Author
Andrea Delle Sedie
  • Function : Author
Emmanuelle Dernis
  • Function : Author
Sandrine Guis
  • Function : Author
Philip Helliwell
Pauline Ho
  • Function : Author
Axel Hueber
  • Function : Author
Beatriz Joven
  • Function : Author
Michaela Koehm
  • Function : Author
Carlos Montilla
  • Function : Author
Jon Packham
  • Function : Author
José Antonio Pinto Tasende
Felipe Julio Ramirez Garcia
Adeline Ruyssen-Witrand
  • Function : Author
Rossana Scrivo
Sarah Twigg
  • Function : Author
Martin Soubrier
Théo Wirth
  • Function : Author
Laura Coates

Abstract

Abstract Objectives Shared decision-making (SDM) is advocated to improve patient outcomes in PsA. We analysed current prescribing practices and the extent of SDM in PsA across Europe. Methods The ASSIST study was a cross-sectional observational study of PsA patients ≥18 years of age attending face-to-face appointments between July 2021 and March 2022. Patient demographics, current treatment and treatment decisions were recorded. SDM was measured by the clinician’s effort to collaborate (CollaboRATE questionnaire) and patient communication confidence (PEPPI-5 tool). Results A total of 503 patients were included from 24 centres across the UK, France, Germany, Italy and Spain. Physician- and patient-reported measures of disease activity were highest in the UK. Conventional synthetic DMARDs constituted a higher percentage of current PsA treatment in the UK than continental Europe (66.4% vs 44.9%), which differed from biologic DMARDs (36.4% vs 64.4%). Implementing treatment escalation was most common in the UK. CollaboRATE and PEPPI-5 scores were high across centres. Of 31 patients with low CollaboRATE scores (<4.5), no patients with low PsAID-12 scores (<5) had treatment escalation. However, of 465 patients with CollaboRATE scores ≥4.5, 59 patients with low PsAID-12 scores received treatment escalation. Conclusions Higher rates of treatment escalation seen in the UK may be explained by higher disease activity and a younger cohort. High levels of collaboration in face-to-face PsA consultations suggests effective implementation of the SDM approach. Our data indicate that in patients with mild disease activity, only those with higher perceived collaboration underwent treatment escalation. Prospective studies should examine the impact of SDM on PsA patient outcomes. Trial registration clinicaltrials.gov, NCT05171270.

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Dates and versions

hal-04404853 , version 1 (19-01-2024)

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Lily Watson, Conor Coyle, Caroline Whately-Smith, Melanie Brooke, Uta Kiltz, et al.. An international multicentre analysis of current prescribing practices and shared decision-making in psoriatic arthritis. Rheumatology, In press, 25 (1), pp.109. ⟨10.1093/rheumatology/kead621⟩. ⟨hal-04404853⟩
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