Background The impact of psoriatic arthritis (PsA) is wide-reaching and covers various aspects of life, e.g., physical, psychological and social. This impact could be categorised using a universally accepted, standardized reference system: the International Classification of Functioning, Disability and Health (ICF).
Objectives The objective was to assess how the impact of PsA from the patient's perspective mapped to the ICF.
Methods Data sources: Publications with dimensions of health important for PsA patients were identified through a systematic literature review using the following terms: (“psoriatic arthritis”) AND (“quality of life” OR “impact”). Only studies related to impact from the patient's perspective, i.e., studies using qualitative methodology (e.g., focus groups, individual interviews) or instruments that were patient derived (patients included in the development task force, development based on qualitative methods) were included. Data extraction and interpretation: Domains of health important for patients were identified. Meaningful concepts were extracted from the publications and linked to the ICF categories, according to the updated linking rules  by 2 persons. The number of concepts linked to each ICF category and to each ICF level was calculated. The number of concepts not linkable was also calculated. Descriptive statistics were used.
Results Eleven studies (13 articles) were included in the analysis, corresponding to 2893 patients (of whom 623 assessed qualitatively); two studies did not precisely define the population involved in their qualitative phases. Eight studies were exclusively on PsA and the other 5 included also patients with only psoriasis; only 5 studies were qualitative per se. Twenty-five domains of health were cited, of which Ability to work/volunteer and Social participation were most cited (both by 10 studies). In total 258 concepts were identified, of which 217 (84.1%) could be linked to 136 different ICF categories; 41 concepts (15.9%), mostly personal factors, namely coping with the disease (21 concepts; 51.21%) could not be linked. The most represented ICF component was Activities and Participation (42.6%) rather than Body functions (29.4%) or Body structures (10.3%). Ten studies (90.9%) reported impairments in Ability to work/volunteer and Social participation; 7 (63.6%) reported Leisure activities, Family and intimacy, Pain, Skin problems and Body image.
Conclusions PsA widely impacts all aspects of patients' lives, in particular regarding activities and participation, reflecting the functional limitations, but also the psycho-social and societal burden of PsA. The ICF is a useful approach for the systematic classification of disease impact.
Cieza A, Geyh S, Chatterji S et al. ICF linking rules: an update based on lessons learned. J Rehabil Med 2005;37:212–8.
Acknowledgement Dr. Gudu's work was supported by a scientific training bursary of the European League Against Rheumatism.
Disclosure of Interest None declared
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