June 19, 2015
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Fatigue scores differ between patient, physician reports in rheumatic diseases

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Physicians were more likely to score patient fatigue lower than patient-reported scores among patients with rheumatoid arthritis, osteoarthritis, systemic lupus erythematosus and fibromyalgia, according to research presented at the European League Against Rheumatism Annual European Congress of Rheumatology.

Researchers enrolled 173 patients with rheumatoid arthritis (RA), 199 patients with osteoarthritis (OA), 146 patients with systemic lupus erythematosus (SLE) and 94 patients with fibromyalgia (FM) from one academic clinic. Prior to meeting with a rheumatologist for usual care, patients completed a multidimensional health assessment questionnaire (MDHAQ) in 5 minutes to 10 minutes in the waiting area. The two-page assessment included questions about physical function in 10 daily activities, three 0 to 10 VAS assessments of pain, patient global estimate and fatigue. Four disease activity categories were defined using demographic data, the patient global estimate and the physician global estimate to measure disease activity from inactive disease, low, moderate and high.

The median values of fatigue were compared between the four groups. Fatigue scores were higher in the presence of high disease activity in patients RA, OA and SLE, but disease activity did not correlate with fatigue in patients with FM, according to the researchers.

Results of the physician global estimate demonstrated that the physicians’ assessment showed a smaller percentage of patients categorized as having high fatigue than the patients’ assessment. In patients with RA, 28% and 31% reported moderate and high fatigue, respectively, whereas physicians reported that 39% had moderate levels and 15% had high levels of fatigue.

In patients with OA, 33% of patients reported moderate levels of fatigue based on the MDHAQ and 43% reported high fatigue compared with 62% and 14% for moderate and high fatigue, respectively, by the physician.

Among patients with SLE, 29% reported moderate fatigue and 30% reported high fatigue compared with 34% and 10%, respectively, as reported by physicians. In patients with FM, 25% reported moderate fatigue and 67% reported high fatigue compared with the physician report of 69% with moderate fatigue and 22% with high fatigue.

Low fatigue was reported by 18% of patients with RA, 12% of patients with OA, 16% of patients with SLE and 8% of patients with FM in contrast to 33%, 17%, 35% and 8% reported by physicians. Remission was reported in 23%, 12%, 25% and no patients with RA, OA, SLE and FM, respectively, compared with 13%, 7%, 21% and 2% as assessed by the physician global estimate. – by Shirley Pulawski

Reference:

Castrejon I, et al. Paper #SAT0343. Presented at: European League Against Rheumatism Annual European Congress of Rheumatology; June 10-13, 2015; Rome.

Disclosure: The researchers report no relevant financial disclosures.