For people suffering from rheumatoid arthritis, pain is the crucial factor in their personal perception of the condition. The doctors treating them, however, assess the severity of the disease based on the swelling of the joints. This discrepancy often leads to conflict between patients and their physicians, as a study by Daniel Aletaha and Paul Studenic from the University Department of Internal Medicine III at the MedUni Vienna has now revealed in more detail for the first time.
The study, which involved 646 patients, has now been published in the journal Arthritis and Rheumatism.
"Our study has quantified for the first time what we already intuitively knew," explains Aletaha. For patients, the perception of the condition is 75 per cent shaped by the pain they are experiencing, while their physicians' perception of the illness is 60 per cent determined by the number of swollen joints. "We wanted to make people aware of this. Our work is also a call to improve the communication between doctors and patients with rheumatoid arthritis."
The discrepancy, however, lies not only in the present perception of the disease, but also in the further stages of treatment. Says Aletaha: "The patient focuses primarily on their current situation, however the doctor may flag up possible long-term effects and organise treatment based on these, even if the patient does not currently have any pain. This leads to the patient sometimes being unable to understand why the physician wants to change their medication." On the other hand, the patient's perception of the condition is so greatly influenced by pain that they usually classify their condition as much worse than their physicians, says Studenic.
The results of the study are intended to provide a starting point for improved communication between the two sides. Says Aletaha: "The key concept here is 'shared decision-making'. The objective must be to create greater proximity between the doctor and the patient."
- Paul Studenic, Helga Radner, Josef S Smolen, Daniel Aletaha. Discrepancies between patients and physicians in the perception of rheumatoid arthritis disease activity. Arthritis & Rheumatism, 2012; DOI: 10.1002/art.34543
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