There is a significant gap in symptom concordance between PAH patients and their physicians, with physicians frequently underestimating symptom presence and severity.
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Discordance in PAH symptom reporting was linked to worse HRQoL; leaves open whether alignment strategies improve patient outcomes.
This study involved analyses of a real world, cross-sectional survey of physicians and their patients with pulmonary arterial hypertension (PAH). Physician and patient symptom concordance was assessed, and patients self-reported Health-Related Quality of Life (HRQoL). Data were drawn from the Adelphi PAH Disease Specific Programme (DSP)™ in the United States, France, Germany, Italy, Spain, United Kingdom, and Japan, between March and August 2022. EQ-5D 5L utility, EQ-5D Visual Analogue Scale (VAS) scores, and emPHasis-10 (e10) HRQoL scores were reported by patients. Physician-patient symptom concordance was analyzed with Cohen's Weighted Kappa (κ) analysis. Of 628 PAH patients, the mean (SD) EQ-5D VAS and e10 scores were 66 (17) and 23 (11). Data was stratified by World Health Organization Functional Class (WHO-FC). As WHO-FC increased, EQ-5D utility and VAS scores decreased and e10 scores increased, indicating poorer patient-reported HRQoL. Symptom concordance varied, ranging from κ = 0.11-0.57 (slight-moderate agreement), and physicians frequently underestimated the presence and severity of patient-reported symptoms. Future research should aim to bridge this gap between patient and physician understanding of HRQoL and the symptom burden associated with PAH.
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White et al. (2024) studied this question.
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