The relationship between patient satisfaction with health and clinical measures of function and disease status in patients with psoriatic arthritis

OBJECTIVE: To investigate whether patient satisfaction with health is a distinct aspect of clinical or health status in a sample of patients with psoriatic arthritis (PsA). METHODS: One hundred sixty-nine consecutive outpatients attending the University of Toronto PsA Clinic completed the Arthritis Impact Measurement Scales II (AIMS2), which includes both a global rating of patient satisfaction with health and a scale that assesses satisfaction with functioning in 12 health domains. Clinical, laboratory, and radiological assessments of function, pain, inflammation, and damage were also performed according to a standard protocol. RESULTS: Logistic regression analysis indicated that the AIMS2 global ratings of patient satisfaction with health were not associated with traditional clinical measures of inflammation and damage, but were associated with American College of Rheumatology (ACR) functional class and number of fibromyalgia tender points. Patient satisfaction was also related to annual family income and use of retinoids or corticosteroids. Similarly, linear regression analysis showed that scores on the AIMS2 satisfaction scale were unrelated to traditional clinical measures of inflammation and damage, with the exception of total number of actively inflamed joints. ACR functional class, annual family income, and comorbidity were also related to scores on the satisfaction scale. CONCLUSION: Patient satisfaction with health appears to be relatively independent of traditional clinical measures of physical functioning, pain, and disease status.