TY - THES ID - 137308208 TI - Patient-Physician Discrepancy in Experiences and Perception Towards Flares in Rheumatoid Arthritis: A Scoping Review AU - Diricks, Lotte AU - Verschueren, Patrick AU - Pazmiño Lucio, Sofia AU - De Meyst, Elias AU - Doumen, Michaël AU - Bertrand, Delphine AU - KU Leuven. Faculteit Geneeskunde. Opleiding Master in de geneeskunde (Leuven) PY - 2023 PB - Leuven KU Leuven. Faculteit Geneeskunde DB - UniCat UR - https://www.unicat.be/uniCat?func=search&query=sysid:137308208 AB - Objective: This scoping review aims to identify the heterogeneity in flare definitions of rheumatoid arthritis (RA) and the discordance between patients and physicians in defining flares. Methods: We performed a systematic search of PubMed, EMBASE, Web of Science core collection, Cochrane Library, and CINAHL for publications reporting the term “flare” or related terms. Quantitative and qualitative studies that included adult patients with RA, were peer-reviewed, and published in English were included. Flare definitions from quantitative studies were summarized descriptively. Additionally, a thematic synthesis of the qualitative studies further explored the concept of a flare. Results: In total, 30.043 articles were identified, of which 259 articles were included. Flare definitions were categorized in patient-based definitions, physician-reported definitions, and definitions based on disease activity indices using various thresholds. Most articles defined flares by the DAS28-criteria, whereas DAS-criteria, CDAI-score and SDAI-score were adopted to a lesser extent. Patients defined their flares with self-administered questionnaires (e.g., FLARE-RA, RA-FQ, RADAI-5), affirmation to an anchor question, or symptom worsening. By contrast, physicians described flares by a need for treatment change, their own judgment, or joint count. Our thematic synthesis resulted in three themes: (1) defining a flare in a fluctuating disease course, (2) discordance between patients and physicians, and (3) challenges of RA flares in daily life. Conclusion: This scoping review provides a comprehensive assessment of the literature on the conceptualization of an RA flare. Future work is required to pursue homogeneity and reach consensus on a standardized flare definition for clinical studies and daily practice. ER -