Ab0368 differences in the assessment of comorbidities (fatigue and depression) between ra patients and physicians. do we measure the same?

Background Differences in physicians’ assessment of disease activity and patients’ perception of disease activity have been described [1]. Two of the most important disease-related symptoms experienced by patients are fatigue and depression, which are not routinely assessed by physicians [2]. Objectives To study the differences between patient and physician perspectives on fatigue and depression, as well as on other biological, clinical and self-reported disease variables in a group of patients with established rheumatoid arthritis (RA). Methods Patients with RA (ACR/EULAR,2010) followed up by the Arthritis Unit who agreed to participate in this study were included consecutively in the Arthritis Unit for 3 months. They fulfilled 3 questionnaires to evaluate fatigue and depression: 1. MDHAQ, that includes: 0-10 physical function (FN) according to modified HAQ (0-10), visual analogue scale (VAS) 0-10 for pain (PN), VAS 0-10 for fatigue (VAS-Fatigue) (in the question 9, considering high fatigue with >5 cut off) and patient global assessment (PGA) to calculate RAPID3, a review of 60 symptoms (ROS60) and self-assessment 48 joint count (RADAI48). 2. FACIT-(FS)=FACIT-Fatigue, 13 questions (0-4 score) with a global score of 0-52 (lower scores indicate worse fatigue). 3. Patient Health Questionnaire 9= PHQ9, 10 questions with PHQ9>10 screened for depression. Physical articular examination (28TJC, 28SJC), laboratory test (CRP, ESR), composite EULAR disease activity indices (DAS28, DAS28 CRP, CDAI and SDAI), demographic (sex, age, BMI), patient´s disease characteristics and the Physician Global Assessment (PhGA) for the disease were collected. A descriptive analysis of the variables was done, and Pearson´s correlation between PhGA and PGA, and the rest of variables studied was performed. Results A total of 75 patients (84% females) with RA were recruited, with a mean age of 62±11.6 years, a mean disease duration of 14.6± 5 years and a mean BMI of 22.8 ± 8.0. 64% were under with bDMARD and 45.3% with glucocorticoids treatment. Depression (PHQ9>10) was observed in 12 patients (16%) and in 31 (41.2%) of patients we observed high fatigue (VAS-fatigue>5/10). Correlation results between PGA and Fatigue (FS) were almost good for VAS-Fatigue (r=0.604, p<0.001) and for PHQ9>10(r=0.616, p<0.001), and almost good for FACIT(FS)(r=-0.517, p<0.001). On the other hand, correlations between PhGA were smaller with fatigue (Fatigue (FS): r=-0.428, p<0.001; VAS-Fatigue: r=0.451 p<0.001) and with depression (PHQ9: r= 0,477 p<0.001). Correlation of the rest of studied variables (DAS28, CDAI, SDAI, 28TJC, 28SJC, CRP, ESR and ROS) were smaller for PhGA than for PGA, except for 28SJC, where the assessment of physician is closer to that the patient (Table 1). Conclusion The patient’s perception of disease status is better than the physician’s perception of these two important comorbidities associated with RA, as well as disease activity indices. Clinicians have to take into account scores on fatigue and depression questionnaires or scales when assessing patients with RA. References [1] Inciarte-Mundo J, et al. Ann Rheum Dis 2020, 79 (Suppl 1) 596. [2] Katz P, et al. Arthritis Care Res (Hoboken) 2016;68:81-90. Acknowledgements: NIL. Disclosure of Interests Rosa Morlà: None declared, Beatriz Frade-Sosa: None declared, Nuria Sapena: None declared, José A Gómez-Puerta Speakers bureau: Abbvie, Astra Zeneca, Lilly, Galápagos, Pfizer, Roche, Consultant of: Abbvie, Astra Zeneca, Lilly, Galápagos, Pfizer, Roche, Raimón Sanmartí Speakers bureau: Abbvie, Lilly, Pfizer, Roche, Consultant of: Abbvie, Lilly, Pfizer, Roche.