Association between patient characteristics, demographics, and social determinants of health with treatment-refractory and complex-to-manage psoriatic arthritis

Abstract

Objectives Psoriatic arthritis (PsA) is a heterogeneous disease that presents challenges in both diagnosis and treatment. To address the disease burden, the Group of Research and Association of Psoriasis and Psoriatic Arthritis conducted surveys with patients to gain insights into patient experiences regarding treatment-refractory (TR-) and complex-to-manage (C2M-) PsA. The objective of this study was to analyse patient responses to open-ended questions. Methods A descriptive inductive coding approach was applied in Dedoose software [SocioCultural Research Consultants, LLC (SCRC)] to systematically analyse demographic variables in terms of relevant thematic codes for health-related quality of life, work, and financial concerns. Results We found that TR/C2M-PsA narratives consistently highlighted themes of negative impact on health-related quality of life, work, and finances, and these effects were perceived with varying intensities among both genders, across age groups, languages, and disease manifestations. Social determinants of health, including education attainment, occupation and relationship status, also played an important role in influencing patient responses regarding TR/C2M-PsA. Conclusions This study addresses an important gap in the literature regarding the impact of TR/C2M-PsA on patient experience. We observed a critical role of demographic factors and social determinants of health in the narrative themes of patients with high disease burden.