Factors Associated With Diagnosing Psoriatic Arthritis: A Retrospective Study in Northeast Georgia.

Abstract

Background: Approximately 15.5% of patients with psoriatic arthritis (PsA) are currently not diagnosed or experience delayed diagnosis with negative outcomes. This retrospective, cross-sectional study evaluated patients with psoriasis to determine what factors were associated with diagnosis of PsA.

Methods: A retrospective chart review was performed using electronic medical record from primary care clinics across the northeast Georgia region. The study population included patients with psoriasis evaluated in the clinic between January 1, 2017 and December 31, 2022. Patients with PsA were compared to those without PsA to assess for factors associated with the diagnosis of PsA.

Results: The probability of diagnosis of PsA increased with increasing number of clinic encounters (odds ratio [OR], 1.18; P < .05). Males (OR, 0.634; P < .001) were less likely to be diagnosed compared to females. Patients with Medicare (adjusted OR, 1.707; 95% confidence interval [CI], 1.027-2.837; P < .05) and commercial/private insurances (adjusted OR, 2.043; 95% CI, 1.28-3.258; P < .01) had a higher chance of being diagnosed in comparison to patients with Medicaid. Black patients were less likely to be diagnosed compared to White patients (OR, 0.231; P < .001). Hispanic patients were less likely to be diagnosed with PsA compared to patients who were not Hispanic (OR, 0.2; 95% CI, 0.07-0.51; P < .05).

Conclusions: The study highlighted potential factors associated with the diagnosis of PsA among patients with psoriasis. Sex, race, ethnicity, number of clinic encounters, and insurance type were all found to have associations with likelihood of receiving a PsA diagnosis. These findings were hypothesis-generating and suggest potential disparities in care, particularly for diverse populations, warranting further research.