Investigating the relationship between psoriatic arthritis, multiple long-term conditions, treatment burden and adverse clinical outcomes: A systematic review protocol.

BACKGROUND

Psoriatic arthritis (PsA) is a chronic inflammatory musculoskeletal disease associated with psoriasis, affecting an estimated 0.13% of adults worldwide. People living with PsA often experience multiple long-term conditions (MLTCs) or multimorbidity (the presence of two or more long-term health conditions), such as hypertension, diabetes, obesity, and metabolic syndrome. Multimorbidity and treatment burden which is the workload of healthcare experienced by individuals and its impact on wellbeing may exacerbate poor health outcomes and complicate disease management in PsA. However, the influence of MLTCs and/or treatment burden on adverse health-related outcomes in this population remains poorly understood.

OBJECTIVE

This systematic review protocol will outline the methods to evaluate the current evidence regarding the impact, if any, of MLTCs and/or treatment burden on mortality and other adverse health-related outcomes in individuals with PsA.

DESIGN

Systematic review of the literature. The following databases will be searched: MEDLINE, EMBASE, CINAHL, PsycINFO, and Scopus. Longitudinal quantitative studies will be eligible for inclusion. Study selection will follow predefined eligibility criteria, and methodological quality and risk of bias will be assessed using the Cochrane Quality in Prognostic Studies tool. A narrative synthesis will be undertaken, and meta-analysis will be considered where appropriate. This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) 2015 guidelines.

CONCLUSIONS

Understanding the impact of MLTCs and/or treatment burden on health-related outcomes in PsA is essential for improving future clinical management. This review will help identify existing knowledge gaps and advance precision medicine strategies to improve health-related outcomes for individuals living with PsA.