P179 Shared decision-making in psoriatic arthritis consultations
Authors: Watson Lily L , Coyle Conor , Brooke Melanie , Kiltz Uta , Lubrano Ennio , Queiro Rubén , Trigos David , Brandt-Juergens Jan , D'Angelo Salvatore , Sedie Andrea Delle , Dernis Emmanuelle , Helliwell Philip , Ho Pauline , Hueber Axel , Joven Beatriz , Koehm Michaela , Montilla Carlos , Packham Jon , Tasende José P , Garcia Felipe J R , Ruyssen-Witrand Adeline , Scrivo Rossana , Twigg Sarah , Welcker Martin , Soubrier Martin , Wirth Theo , Gossec Laure , Coates Laura C 
Published: April 2023

Abstract

Background/Aims
A personalised approach is required to optimise management of psoriatic arthritis (PsA). Shared decision-making between physician and patient is key, resulting in greater patient satisfaction and outcomes. We assessed the degree of perceived collaboration following clinic visits in the UK and Europe and whether this was associated with treatment escalation.

Methods
The ASSIST study was a cross-sectional observational study of PsA patients aged 18 years and older selected from 24 centres across 5 countries (UK, France, Germany, Italy and Spain) between July 2021 and March 2022 (IRAS: 287039). Patients attending a face-to-face appointment with a diagnosis of PsA made by a rheumatologist were selected by systematic sampling at each centre and treated in routine clinical practice. Patients completed the collaboRATE questionnaire (scored 0-9), where high scores indicate greater perceived collaboration. The perceived efficacy in patient-physician interactions (PEPPI) tool (scored 5-25) assessed the patients’ view on their confidence in the consultation. Patient, physician, and disease characteristics were recorded, alongside treatment decisions (medications unchanged, switched, added or reduced). The analysis was descriptive, with no imputation of missing data.

Results
503 patients were included, with key characteristics shown (Table 1). Generally, the level of disease severity was low (mean total PsAID score 3.6/10) and PEPPI scores were high, indicating patient confidence in the consultation. A subgroup (n = 10) perceived difficulty in sharing their concerns (PEPPI &lt;12/25). However, collaboRATE scores remained high (mean score 7.96), suggesting satisfaction in the physician’s effort to understand patient concerns. Consultation satisfaction was not associated with treatment decisions: mean collaboRATE and PEPPI scores in those with and without treatment escalation were similar. Mean collaboRATE and PsAID scores were not associated. In patients with low collaboRATE scores (&lt;5), only patients with higher PsAID scores (&gt;5) had treatment escalation. However, in patients with high collaboRATE scores, even patients with low PsAID scores had treatment escalation.

Conclusion
Patients report high levels of shared decision-making in face-to-face PsA consultations, unrelated to treatment escalation. In patients with low PsAID scores, those with higher perceived collaboration are more likely to have treatment escalation than those without, perhaps reflecting the identification of otherwise undetected symptoms/concerns.
Disclosure
L.L. Watson: None. C. Coyle: None. M. Brooke: None. U. Kiltz: None. E. Lubrano: None. R. Queiro: None. D. Trigos: None. J. Brandt-Juergens: None. S. D'Angelo: None. A. Delle Sedie : None. E. Dernis: None. P. Helliwell: None. P. Ho: None. A. Hueber: None. B. Joven: None. M. Koehm: None. C. Montilla: None. J. Packham: None. J.P. Tasende: None. F.J.R. Garcia: None. A. Ruyssen-Witrand: None. R. Scrivo: None. S. Twigg: None. M. Welcker: None. M. Soubrier: None. T. Wirth: None. L. Gossec: Consultancies; AbbVie, Amgen, BMS, Celltrion, Galapagos, Gilead, GSK, Janssen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB. Grants/research support; Amgen, Galapagos, Lilly, Pfizer, Sandoz, UCB. L.C. Coates: None.