Mapping the effect of psoriatic arthritis using the international classification of functioning, disability and health

Objective. The effect of a disease can be categorized by a standardized reference system: The International Classification of Functioning, Disability and Health (ICF). The objective was to map the effect of psoriatic arthritis (PsA) from the patient's perspective to the ICF. Methods. A systematic literature review was performed. Qualitative publications reporting domains of impact important for patients with PsA were identified using the following terms: ("psoriatic arthritis") AND ("quality of life" OR "impact"). Meaningful concepts were extracted from the publications, grouped into domains and linked to the ICF categories. The number of concepts linked to each ICF category and to each ICF level was calculated. The number of concepts not linkable was also calculated. Results. Eleven studies (13 articles) were included in the analysis. Twenty-five domains of impact were cited, of which the ability to work/volunteer and social participation were the most cited (both by 10 studies). In total, 258 concepts were identified, of which 217 could be linked to 136 different ICF categories; 41 concepts, mostly personal factors, could not be precisely linked. The most represented ICF component was activities and participation (42.6%) rather than body structures (10.3%) or body functions (29.4%). Ten studies (90.9%) reported impairments in the ability to work/volunteer and social participation, and 7 (63.6%) reported leisure activities, family and intimacy, pain, skin problems, and body image. Conclusion. PsA widely affects all aspects of patients' lives, in particular aspects related to activities and participation. The ICF is a useful approach for the classification of disease effect.