Table 1.
Association of patient characteristics with patient-provider discordance in global assessments of disease activity in the total study population
| Characteristic | All patients (N = 339) |
Concordant group (n = 236) |
Discordant groupa
(n = 103) |
P value |
|---|---|---|---|---|
| Age, years | 63.5 (55.1–72.8) | 62.4 (55.1–73.8) | 63.5 (54.9–72.0) | .79 |
| Sex | .15 | |||
| Female | 235 (69) | 158 (67) | 77 (75) | |
| Male | 104 (31) | 78 (33) | 26 (25) | |
| Disease duration, years | 7.0 (2.7, 11.4) | 7.4 (3.5, 11.7) | 6.3 (2.2, 8.8) | .53 |
| Provider type | .63 | |||
| NP/PA | 230 (68) | 160 (68) | 70 (68) | |
| Physician | 90 (27) | 61 (26) | 29 (28) | |
| Fellow | 19 (6) | 15 (6) | 4 (4) | |
| Comorbidity | ||||
| Fibromyalgia | 28 (8) | 10 (4) | 18 (17) | < .001 |
| Depression | 101 (30) | 61 (26) | 40 (39) | .02 |
| Osteoarthritis | 184 (54) | 121 (51) | 63 (61) | .09 |
| Sleep apnea | 63 (19) | 47 (20) | 16 (16) | .34 |
| Obesity (BMI ≥ 30 kg/m2) | 130 (42) | 87 (39) | 43 (47) | .19 |
| BMI, kg/m2 | 28.5 (25.1–33.7) | 28.4 (24.2–32.9) | 29.4 (26.5–35.4) | .03 |
| Disease assessment | ||||
| Patient global, 0-100 | 33 (11–57) | 20 (6–44) | 57 (46–72) | < .001 |
| Provider global, 0-100 | 15 (5–30) | 15 (5–40) | 15 (10–20) | .20 |
| Pain VAS, 0-100 | 38 (15–63) | 24 (9–50) | 60 (44–73) | < .001 |
| Tender joint count ≥ 2 | 121 (36) | 75 (32) | 46 (45) | .02 |
| Swollen joint count ≥ 2 | 122 (36) | 82 (35) | 40 (39) | .47 |
| DAS28-CRP | 3.0 (2.2–4.4) | 2.6 (1.9–4.1) | 3.7 (2.7–4.7) | .004 |
| CDAI | 7.5 (3.0–14.5) | 5.6 (2.0–13.8) | 9.8 (6.5–15.6) | < .001 |
| Remission, < 2.8 | 80 (24) | 78 (33) | 2 (2) | < .001 |
| LDA, ≥ 2.8 to < 10.0 | 130 (38) | 79 (33) | 51 (50) | |
| MDA, ≥ 10.0 to < 22.0 | 89 (26) | 51 (22) | 38 (37) | |
| HDA, ≥ 22.0 | 40 (12) | 28 (12) | 12 (12) | |
| Laboratory assessment | ||||
| CRP, mg/L | 3.2 (2.9–9.2) | 3.3 (2.9–9.4) | 3.2 (2.9–9.2) | .96 |
| RF positivity | 233 (71) | 173 (75) | 60 (61) | .01 |
| Anti-CCP antibody positivity | 201 (67) | 146 (71) | 55 (59) | .045 |
| Radiographic joint erosion | 172 (52) | 133 (57) | 39 (39) | .002 |
| Medication use | ||||
| Prednisone | 150 (44) | 101 (43) | 49 (48) | .42 |
| Methotrexate | 215 (63) | 148 (63) | 67 (65) | .68 |
| Biologics | 125 (37) | 83 (35) | 42 (41) | .33 |
| Change of RA medications at index visit | 91 (27) | 69 (29) | 22 (21) | .13 |
| Opioid | 78 (23) | 45 (19) | 33 (32) | .009 |
| Fibromyalgia med | 33 (10) | 16 (7) | 17 (17) | .005 |
| Sleep aid | 36 (11) | 18 (8) | 18 (17) | .007 |
| Antidepressant or anxiolytic | 80 (24) | 45 (19) | 35 (34) | .003 |
aValues are presented as median (interquartile range) or number (percentage)
bDiscordant group contains only those patients with a global assessment greater than the physician global assessment
anti-CCP anticyclic citrullinated peptide, BMI body mass index, CDAI Clinical Disease Activity Index, CRP C-reactive protein, DAS28-CRP Disease Activity Score in 28 joints using C-reactive protein, DMARD disease-modifying antirheumatic drug, HDA high disease activity, LDA low disease activity, MDA moderate disease activity, NP nurse practitioner, PA physician assistant, RA rheumatoid arthritis, RF rheumatoid factor