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AB0268 How do patients with rheumatoid arthritis evaluate their global assessment?
  1. M. Kojima1,
  2. T. Kojima2
  1. 1Medical Education, Nagoya City University Graduate School of Medical Sciences
  2. 2Orthopedic Surgery, Nagoya University Hospital, Nagoya, Japan


Background The importance of patient-reported outcomes (PRO) has been recently recognised. Patient global assessment (PtGA) is one of the most popular PROs in rheumatology. However, the validity of PtGA as a tool for assessment of disease activity and its relevance compared with other tools is still debated.1 Patients‘ perspective is essential to achieve treat-to-target. The significance of measuring PtGA in clinical practice should be verified. We previously found that Japanese rheumatologists changed their strategy to ask patient global assessment (PtGA) according to the patients‘ understanding ability. It is unknown how patients themselves feel PtGA.

Objectives To investigate how patients with rheumatoid arthritis (RA) evaluate and accept PtGA as assessment tool of RA activity.

Methods During the period of ,August and September, 2016 a 90 min focus group was held four times. Nine or 10 RA patients participated in each focus group. Totally, 34 women and 4 men, average age 56.1±10.9 years old, and disease history 9.39±9. 36 years joined the study. The participants freely discussed how to evaluate their conditions of rheumatism and therapeutic effect. We used the “Steps for Coding and Theorization” (SCAT)2–3 to analyse the focus group data.

Results Patients determined their PtGA based on pain, swelling, inconvenience of daily life, the mood of the day, comprehensively, although they felt confusing because the criteria of how to evaluate PtGA was unclear. Most patients set 100 of PtGA as ”when most painful after onset”, while standard of 0 was varied. Many patients had experienced a discrepancy between PtGA and CRP that their doctors denied. Patients were eager that their doctor would understand the discordance between PtGA and laboratory data and ask the patients “what’s wrong with you?”

Conclusions Doctors and patients should discuss how to evaluate PtGA at the start of treatment to avoid patients’ confusing. By utilising PtGA as a communication tool, relationship between doctor and patients would be facilitated.

References [1] Kojima M, Kojima T, Suzuki S, Takahashi N, Funahashi K, Asai S, Yoshioka Y, Terabe K, Asai N, Takemoto T, Ishiguro N. Patient-reported outcomes as assessment tools and predictors of long-term prognosis: a 7-year follow-up study of patients with rheumatoid arthritis. Int J Rheum Dis. 2017;20(9):1193–1200.

[2] Otani T. ”SCAT” A qualitative data analysis method by four-setp coding: Easy startable and small scale data-applicable process of theorization.Bulletin of the Graduate School of Education and Human Development (Educational Sciences), Nagoya University2007;54:27–44.

[3] Kojima M, Nakayama T, Otani T, Hasegawa M, Kawahito Y, Kaneko Y, Kishimoto M, Hirata S, Seto Y, Endo H, Ito H, Kojima T, Nishida K, Matsushita I, Tsutani K, Igarashi A, Kamatani N, Miyasaka N, Yamanaka H. Integrating patients’ perceptions into clinical practice guidelines for the management of rheumatoid arthritis in Japan. Mod Rheumatol. 2017;27(6):924–929.

Disclosure of Interest None declared

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