Involvement, satisfaction and unmet health care needs in patients with psoriatic arthritis

Objective. To examine the involvement in care, participation in medical decision, satisfaction of health care and unmet needs in patients with PsA. To explore factors related to involvement and satisfaction with care. Methods. One hundred and five patients with PsA attending four regional hospital rheumatology outpatient clinics were invited and consented to self-administer questionnaires, including socio-demographic data, quality of life with SF-12, involvement in medical decision, satisfaction with care and unmet health care needs. Results. The overall perceived knowledge of disease was moderate. Good disease knowledge and good physical functioning were positively associated with involvement in care. Age, sex and pain scores were not associated with involvement in multivariate analysis. A low score in at least one question on involvement was the single independent negative predictor for satisfaction with health care. Only a minority (9%) was actively participating in medical decision-making. Among non-participants, 61.5% expressed the wish to participate. In aspects of education of disease, advice for exercise, psychological support and social support, respectively, 68.3, 73.3, 29.3 and 41.6% of the patients expressed unmet needs. Conclusion. Low involvement is negatively associated with satisfaction with health care in PsA. Good knowledge of disease and good physical functioning is positively associated with involvement. The current study supports patient education as an important factor associated with involvement of and satisfaction with care in PsA patients. Such patients have a high desire for information and numerous unmet health care needs. There is a need for improvement in the delivery of care to patients with PsA.