• Enrique Roberto Soriano, Federico Zazzetti, Ivanio Alves Pereira, José Maldonado Cocco, Valderilio Feijó Azevedo, Generoso Guerra, Wilson Bautista-Molano, Julio César Casasola, David Vega Morales, Diana Rocío Gil, Steve Lobosco, and Fabio Lawson.
• Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
• Clin. Rheumatol. 2020 Jun 1; 39 (6): 1859-1869.

IntroductionPhysician-patient misalignment may exist in real-life clinical practice. We aimed to assess physician and patient treatment satisfaction levels and associated degree of misalignment in psoriatic arthritis (PsA).MethodData from a cross-sectional survey of patients and their physicians conducted in Latin America were analyzed. Physician-reported and patient-reported satisfaction levels with current PsA treatment, alignment in satisfaction levels, and factors associated with satisfaction misalignment were assessed through bivariable and multivariable regression analyses.ResultsA total of 179 physician-patient pairs were analyzed. Physicians reported satisfaction with current disease control in 87.7% (n = 157) of cases; patients reported satisfaction in 91.1% (n = 163 of cases). A total of 82.1% of physician-patient pairs were aligned. Compared with aligned patients, misaligned patients were older and more likely to have moderate or severe disease, deteriorating or unstable disease, a past hospital procedure, current or past psoriasis symptoms, greater current pain, a current acute episode, poorer health and quality of life, greater impairment, poorer medication compliance, to consider PsA a major daily burden, and to believe that PsA treatments were ineffective. Misaligned patients were less likely to be in remission. Logistic regression analysis revealed that misaligned patients were older, and more likely to consider PsA a major daily burden and PsA treatments as ineffective.ConclusionsHigh levels of treatment satisfaction and alignment were observed among PsA patients and their physicians in Latin America. Patients in this study nevertheless experienced a considerable clinical and quality-of-life burden, especially the misaligned patients. Addressing misalignment may lead to improved PsA disease control.Key points• High treatment satisfaction was observed among PsA patients and their treating physicians in Latin America.• Patients experienced a considerable clinical and quality-of-life burden, especially the misaligned patients.• One-fifth of physician-patient pairs were misaligned regarding satisfaction.• Understanding and addressing misalignment may improve outcomes in this patient population.

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