62
5 th World Psoriasis & Psoriatic Arthritis Conference 2018
As early diagnosis and effective treatment is vital to slow down disease progression, individuals with psoriasis as well as healthcare providers need to be educated on symptoms and diagnosis criteria of PsA to prevent undertreatment or treatment that may even be harmful. Disclosure: Project platform and consultancy services were provided by health portal company Netdoktor. The project received funding from Novartis.
P154 AN INTERNATIONAL DELPHI SURVEY TO DEFINE SCREENING FOR PSORIATIC ARTHRITIS AND MEASUREMENT OF PSORIATIC ARTHRITIS
SYMPTOMS IN PSORIASIS CLINICAL TRIALS Lourdes Perez Chada Harvard Medical School-Brigham and Women’ s Hospital
Introduction: The International Dermatology Outcome Measures( IDEOM) group was established to standardize patient-centered outcome measures to improve the assessment of treatment response and disease course in dermatology. To define the measurement set for psoriasis, IDEOM has initially defined a set of domains to be measured in all psoriasis clinical trials representing a“ Core Domain Set”.“ Psoriatic arthritis( PsA) Symptoms” is part of this set. Objectives: To achieve consensus on whether patients enrolling in a psoriasis clinical trial should first be screened for PsA and then with which measure their PsA symptoms should be assessed. Methods: Following the OMERACT( Outcome Measures in Rheumatology) Filter 2.0, the COSMIN guidelines, and based upon the feedback from a consensus meeting held at the IDEOM 2017 Annual Meeting, we conducted an international, multidisciplinary and multi-stakeholder on-line Delphi survey. The survey was organized into 3 parts in which participants were asked to( 1) vote on the role of PsA screening in psoriasis trials,( 2) vote on the quality( measurement properties) of 4 patient-reported instruments: Patient Global( PG)-arthritis associated to a pain assessment tool, PG-Psoriatic Arthritis( PG-PsA) associated to a pain assessment tool, Routine Assessment of Patient Index Data-3( RAPID3), and Psoriatic Arthritis Impact of Disease 9( PsAID9), and( 3) rank these instruments in order of importance. Additionally, respondents were invited to provide feedback on the survey. Results: A total of n = 293, n = 233 and n = 218 subjects completed the PsA screening, instrument quality assessment, and ranking sections of the survey, respectively. The group was comprised of rheumatologists( 44.5 %), dermatologists( 26 %), patients( 7.5 %), industry partners( 8.9 %), dermatologist-rheumatologists( 5.1 %), and patient association representatives( 3.4 %). Results showed that 90 % of participants agreed that all patients enrolling in a psoriasis trial should be screened for PsA. Regarding the quality of the instruments, only the PsAID9reached the pre-specified endpoint of > 70 % with agreement that the instrument has good-to-excellent validity, feasibility, reliability and responsiveness; < 15 % agreed that the quality of the instrument is poor or that there is not enough information to make an informed decision. In the ranking exercise, PsAID9 was the first choice( voted by 48 % of respondents) and RAPID3 represented an acceptable alternative second choice( voted by 33 % of respondents). Conclusion: In this Delphi study, most participants agreed that all psoriasis trial participants should be screened for PsA. Regarding the measurement set for“ PsA Symptoms”, PsAID9 was selected as the most appropriate measure, while RAPID3 could be an acceptable alternative to PsAID9. This will be followed by a workshop at the IDEOM and GRAPPA 2018 annual meetings to review discussion points as well as any need for a second Delphi round.
P155 THE IMPACT OF A DIAGNOSIS ON THE PATIENTS’ PERCEPTION OF TREATMENT AND CARE. RESULTS FROM AN ONLINE SURVEY ON PSORIATIC ARTHRITIS
AND PSORIASIS WITH JOINT PAIN T Norgren, B Bohannan Psoriasisförbundet, Stockholm, Sweden
Introduction: Psoriatic arthritis( PsA) is a chronic inflammatory joint disease that, if untreated, can cause joint destruction and disability. The knowledge about PsA among both public and healthcare providers is limited, leading to underdiagnosis and undertreatment. To raise awareness of PsA and gather relevant data, the Swedish Psoriasis Association and the Swedish Rheumatism Association initiated a web-based educational campaign which also featured a survey on healthcare experiences and Quality of Life. Objectives: The purpose of the survey was to identify the gaps in the healthcare provided for individuals diagnosed with PsA and individuals with psoriasis and joint pain consistent with a PsA diagnosis, as well as understanding the impact on QoL for both groups. Method: The survey consisted of two questionnaires, one for individuals diagnosed with PsA, group A, and one for individuals diagnosed with psoriasis who have joint pain consistent with a PsA diagnosis( using CASPAR criteria), group B. The survey was open from April 6 2017 to March 31 2018. One section of the survey focussed on time to diagnosis and perception of healthcare. Limitations: self-reported diagnosis, possible to take survey multiple times using different devices. Results: Both groups had seen multiple doctors for their joint pain. In group A 60 %( n = 1 132) had seen > 4 doctors, with 11 % reporting having seen > 10. In group B 52.5 %( n = 824) had seen > 4 doctors, with 8 % having seen > 10. In group A nearly 51 %( n = 1 211) reported having had joint pain / symptoms for at least 1 year before receiving a diagnosis, with 12 % waiting > 10 years. In group B 91 %( n = 1 872) reported having had joint pain / symptoms for at least 1 year, with 35 % at > 10 years. Perception of healthcare differed greatly between the groups. In group A over half( n = 1 273) reported that their perception of healthcare improved or improved greatly after receiving their PsA diagnosis. In group B nearly 78 %( n = 1 227) reported being dissatisfied or very dissatisfied with the care they receive. Conclusions: The results show that the group with a PsA diagnosis have a much more positive perception of the treatment and care they receive than the group without a diagnosis. Interestingly, in another part of the survey group B reported their psoriasis having a low to medium impact on their lives, indicating that their psoriasis may be mild enough to be treated in a primary care setting only. In the past few years there have been extensive efforts put into educating Swedish dermatologists on recognizing early signs of PsA, but steps should also be taken to raise awareness of psoriasisassociated joint pain among general practitioners to ensure timely referral to specialist care. Disclosure: Project platform and consultancy services were provided by health portal company Netdoktor. The project received funding from
Novartis. www. medicaljournals. se / acta