AB1682-PARE DIAGNOSIS ANNOUNCEMENT IN RHEUMATOLOGY: EVALUATING PATIENT EXPERIENCES
Authors: W. Lahmar, K. Maatallah, H. Ferjani, F. Majdoub, D. Ben Nessib, L. Kharrat, D. Kaffel, W. Hamdi
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Announcing a diagnosis in rheumatology holds crucial importance for patients with chronic rheumatic diseases. Unlike other medical fields like oncology, little is known about rheumatology announcement practices from the patients' perspective, and how well these protocols meet their needs and expectations. <h3>Objectives:</h3> The aim of this study is to investigate and evaluate the communication practices surrounding diagnostic announcements in rheumatology from the perspective of patients. <h3>Methods:</h3> A descriptive cross-sectional study was conducted involving patients with various chronic rheumatic diseases, including rheumatoid arthritis (RA), spondylarthritis (SpA), psoriatic arthritis (PsA), or undifferentiated rheumatic disease. Sociodemographic data, disease-related information, and details about the diagnosis announcement process were collected through a questionnaire developed collaboratively by two rheumatologists. <h3>Results:</h3> In total, 50 patients were included, with a mean age of 52.4 ± 14.8 years [28 - 77] and a sex ratio of 0.28. The average age at the time of diagnosis was 43.8 ± 15.9 years [18 - 75]. Diagnoses were distributed as follows: 25 (50%) with RA, 15 (30%) with SpA, 4 (8%) with PsA, and 2 with undifferentiated inflammatory disease. The average disease duration was 8.5 ± 6.5 years [1 - 35]. Nine patients (20%) had unfavorable socio-economic conditions, 36 (78%) were married, and in terms of education, 5 patients were illiterate, 17 (34%) had primary education, while 7 (14%) had university degrees. Fourteen patients (28%) used a non-specific Tunisian dialect term to refer to their disease, 19 (38%) described it as an inflammatory joint disease without seeking further specifics, and 15 patients (30%) knew the scientific name of their disease in Arabic or French. All patients remembered the day of the diagnosis announcement. Twenty-seven patients (54%) indicated that their treating physician was the one who made the diagnosis announcement. Sixteen (32%) patients believed their doctor used simple language, while 34 (68%) preferred simpler language. The majority of patients (63%) felt a lack of empathy from the doctor, with 32 (64%) wishing for more empathy. Additionally, 32 patients (64%) found the allocated time insufficient, and 36 (72%) requested more time. In 58% of cases, the announcement took place at the patient's bedside, but patients' preference was for an announcement in the doctor's quiet office. Regarding the information provided, 32 patients (64%) reported that not all information about their disease (vital and functional prognosis, complications, repercussions) was communicated during the announcement, and only 6 preferred a gradual release of information over multiple consultations. Finally, during this announcement, 40 patients (80%) were alone, of which 12 (24%) would have preferred to be accompanied. <h3>Conclusion:</h3> This investigation highlights several problems in diagnosis disclosure practices, emphasizing the need for improved communication of essential information and a more empathetic approach, particularly for patients in potential denial. <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>