Survey shows many patients with RA uncomfortable asking their physicians questions

Pfizer recently released the results of a global survey conducted among more than 3,600 adults with rheumatoid arthritis across 13 countries about patient relationships and communication with their health care provider, as well as satisfaction with disease management.

The survey was conducted between September 2014 and January 2015 and was part of Pfizer’s rheumatoid arthritis (RA) NarRAtive Advisory Panel. A future survey of rheumatologists is planned, as well, according to a press release.

Allan Gibofsky

Among the results of the survey was the finding that many patients are not comfortable asking questions of their physicians.

“What’s interesting is that in the U.S. population, about one in five, or about 20%, worry that if they ask too many questions, it may negatively impact their care,” Cindy McDaniel, senior vice president of Consumer Health at the Arthritis Foundation, told Healio.com/Rheumatology in an interview. “They have the perception that asking questions is not a good thing.”

RA NarRAtive panel member, Allan Gibofsky MD, JD, FACP, FCLM, a professor of Medicine and Public Health at the Weill Medical College of Cornell University and an attending Rheumatologist Hospital for Special Surgery, told Healio.com/Rheumatology that physicians can learn to facilitate communication and improve the quality of interactions with patients using simple techniques, such as making eye contact more often and taking time to listen. The layout of the consultation room, such as where data entry takes place and where the patient sits in relation to the physician, should not interfere with the ability to make eye contact, and similar considerations can help a patient feel more comfortable, according to Gibofsky.

“More and more we are seeing the ergonomics of record-keeping interfere with the encounter with the patient,” Gibofsky said. “Focus on the patient, not the chart.”

Physicians can advise their patients to make a list of questions for the physician before the visit take to minimize anxiety or barriers due to cultural standards, Gibofsky said. McDaniel also noted that physicians can point patients to tools available at the Arthritis Foundation’s website.

According to the survey results, patients with RA who felt comfortable raising concerns with their physician were more likely to characterize their health status as “good” or “excellent” than patients who were uncomfortable (43% vs. 29%).

The survey also showed that nearly four out of five patients (78%) who received prescription medication for RA were satisfied with their treatment, yet only 30% of those patients characterized their symptoms as “under control,” particularly patients with moderate-to-severe RA as characterized by their physician, according to the release.

McDaniel said that one in four patients with RA changed jobs, quit a job or stopped doing something important to them due to RA symptoms, and Gibofsky said it is important to consider functional status in patients with RA.

“As physicians, we may put in the charts that a patient is ‘doing well’ because they aren’t having an adverse event with a medication,” Gibofsky said. “To the patient, ‘doing well’ might mean, ‘Can I cook for my family?’ or ‘Can I clean for myself?’ These disparities need to be addressed.”

Gibofsky said the survey and project are a global initiative to help develop treatment strategies with most likelihood of success.

“The take-home message is this: The role of the physician is to cure a few, help most, but comfort all. We won’t be as successful with [providing] comfort if we’re not communicating with our patients,” Gibofsky said. – by Shirley Pulawski

References: www.pfizer.com, www.arthritis.org.

Disclosure: Gibofsky is a stockholder in AbbVie, Amgen, BMS, Pfizer, J&J, GSK, Regeneron Consultant-AbbVie, Amgen, Pfizer, Horizon, Iroko, Relburn, Celgene, Takeda, Medac and speaker for AbbVie, Amgen, Pfizer, Celgene.