Prevalence, performance of arthritis psoriatic detection tools and cost-effectiveness of early referral in patients with Psoriasis at risk for Arthritis Psoriatica in Primary Care
The SENSOR study

Patients with Psorias (PsO) stay mainly under treatment of their GP.
In about 30% of the patients Psoriatic Arthritis (PsA) will develop over time.
These symptoms require the attention of the rheumatologists for early treatment
to reduce the impact on work and quality of life.
Most GPs having difficulties to discriminate inflammatory joint disease from
the more commonly symptoms of non-inflammatory joint disease.

To estimate the prevalence and burden of disease of PsA among PsO patients in
primary care,.
To test the ability of the PEST(1), the PASE(2) and the EARP(3) to detect cases
with PsA in primary care.
To develop an easy applicable prediction rule for early referral of patients at
risk for PsA.
To estimate the near-term cost-effectiveness of the early referral strategy.

A cross sectional study will be set up

GP practices in the south west region of the Netherlands will be invited to
participate in this study.
After consent the GP databases will be searched for patients coded with ICPC
S91 for psoriasis. These patients will receive a letter from their GP
explaining the study briefly and they will be asked to respond via the attached
return form, email or phone. After they agreed upon participating they will be
invited for a visit to the research nurse at location near their homes,
preferably the GP practice itself or in absence of that opportunity a local
ward building. Patients will be clinically examined for the presence of
psoriasis, arthritis and enthesitis. If they have arthritis, enthesitis or
axial disease they will be referred for a clinical appointment with the
rheumatologists and an ultrasonographic examination will be used to confirm the
clinical findings.