Patient-Reported and Economic Racial and Ethnic Disparities in Patients with Psoriatic Arthritis: Results from the National Health and Wellness Survey.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2024-12-01 Epub Date: 2024-09-29 DOI:10.1007/s40744-024-00717-7

Iris Lin, Kathryn Krupsky, Nate Way, Aarti A Patel, Arlene Tieng

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引用次数: 0

Abstract

Introduction: Psoriatic arthritis (PsA) is a chronic, autoimmune form of arthritis that is associated with a substantial humanistic and economic burden. Potential differences in patient-reported outcomes (PROs) and economic outcomes among groups of varying PsA severity and different races/ethnicities have not been well studied.

Methods: This cross-sectional study assessed sociodemographic data, PROs, and economic outcomes for participants with PsA from the National Health and Wellness Survey (2018-2020). Multivariable analyses were used to assess the association of self-reported PsA severity and race/ethnicity with health-related quality of life (HRQoL), work productivity and activity impairment (WPAI), healthcare resource utilization (HCRU), and medical costs.

Results: This study included 1544 participants with PsA (1073 non-Hispanic white, 114 non-Hispanic Black, 223 Hispanic, and 134 Other). Self-reported moderate/severe PsA was associated with significantly worse HRQoL and WPAI, greater HCRU, and higher costs than self-reported mild PsA. Black participants reported more absenteeism (31.11% vs. 16.69%; P = 0.007) and activity impairment (54.27% vs. 47.96%; P = 0.047) than white participants, and fewer healthcare provider (5.93 vs. 7.42; P = 0.039) and rheumatologist visits (0.29 vs. 0.53; P = 0.028) over the past 6 months. No differences in outcomes were observed between Hispanic and white participants. Race/ethnicity moderated the association of perceived PsA severity and PROs and HCRU, such that white participants with self-reported moderate/severe PsA had a higher likelihood of depression (P < 0.001), lower HRQoL (P < 0.001), and more emergency room visits (P = 0.001) than those with self-reported mild PsA. Race/ethnicity did not moderate the relationship of PROs, HCRU, and economic outcomes among Black or Hispanic participants.

Conclusion: Participants with self-reported moderate/severe PsA reported a greater burden than those with self-reported mild PsA. Black participants had a greater humanistic burden than white participants but reported lower HCRU. Moderation results were driven by white participants, suggesting important differences in PROs, HCRU, and perception of PsA severity across race/ethnicity groups. Small sample sizes in Hispanic and non-Hispanic racial/ethnic groups limited ability to discern differences related to disease severity in these groups. Further research is needed to better understand the differential burden of PsA among individuals with varying perceptions of PsA severity across different racial/ethnic groups.

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银屑病关节炎患者的患者报告和经济方面的种族和民族差异：全国健康与保健调查的结果。

导言：银屑病关节炎（PsA）是一种慢性自身免疫性关节炎，给患者带来巨大的人文和经济负担。对不同 PsA 严重程度和不同种族/族裔群体之间患者报告结果（PROs）和经济结果的潜在差异尚未进行深入研究：这项横断面研究评估了全国健康与保健调查（2018-2020 年）中 PsA 参与者的社会人口学数据、PROs 和经济结果。采用多变量分析评估自我报告的 PsA 严重程度和种族/民族与健康相关生活质量（HRQoL）、工作效率和活动障碍（WPAI）、医疗资源利用率（HCRU）和医疗费用之间的关联：这项研究包括1544名PsA患者（1073名非西班牙裔白人、114名非西班牙裔黑人、223名西班牙裔和134名其他族裔）。与自我报告的轻度 PsA 相比，自我报告的中度/重度 PsA 与更差的 HRQoL 和 WPAI、更高的 HCRU 和更高的费用相关。与白人参与者相比，黑人参与者报告的缺勤率（31.11% vs. 16.69%；P = 0.007）和活动障碍率（54.27% vs. 47.96%；P = 0.047）更高，在过去 6 个月中，他们到医疗机构（5.93 vs. 7.42；P = 0.039）和风湿免疫科就诊（0.29 vs. 0.53；P = 0.028）的次数更少。西班牙裔参与者与白人参与者的结果没有差异。种族/人种调节了感知的 PsA 严重程度与 PROs 和 HCRU 之间的关系，因此自述为中度/重度 PsA 的白人参与者患抑郁症的可能性更高（P = 0.028）：自述中度/重度 PsA 的参与者比自述轻度 PsA 的参与者所承受的负担更大。黑人参与者的人文负担大于白人参与者，但报告的 HCRU 较低。调节结果由白人参与者驱动，表明不同种族/族裔群体在PROs、HCRU和对PsA严重程度的认知方面存在重要差异。西班牙裔和非西班牙裔种族/民族群体的样本量较小，这限制了辨别这些群体中与疾病严重程度相关的差异的能力。要更好地了解不同种族/族裔群体中对 PsA 严重程度有不同认识的人对 PsA 造成的不同负担，还需要进一步的研究。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). For more information on our publishing ethics policies, please see here: https://www.springer.com/gp/editorial-policies Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of rheumatologic therapies. 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For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. For examples of digital features please visit: https://springerhealthcare.com/expertise/publishing-digital-features/ Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Authors should disclose details of preprint posting during the submission process or at any other point during consideration in the journal. 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