Patients with RA prioritize physical function, limiting side effects when choosing therapy
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Key takeaways:
- Patients with rheumatoid arthritis prioritize increasing physical function and reducing severe side effects when assessing options.
- Patients focused on physical function before psychosocial function.
New patients with rheumatoid arthritis are more likely to consider impact on physical function and the potential for adverse events when choosing therapy options, according to data published in BMC Rheumatology.
“Shared decision-making is important in all aspects of RA care, to increase compliance and improve treatment outcomes,” Karin Schölin Bywall, PhD, of Mälardalen University, in Västerås, Sweden, and colleagues wrote. “Ideally, the decision to alter treatment should be aligned with both physicians’ clinical recommendations and patients’ personal preferences.”
To investigate the general preferences of patients who had been diagnosed with RA for fewer than 5 years, Bywall and colleagues conducted a discrete choice experiment among participants from four clinics in Sweden specializing in rheumatologic diseases. Patients were recruited from March to June 2021 if they were aged between 18 and 80 years, demonstrated an insufficient response to first-line monotherapy with methotrexate and if they could participate in the study unaided.
Eligible patients were enrolled through a digital survey that included an introduction, the discrete choice experiment and questions to discern demographic details. Participants responded to 11 hypothetical questions regarding treatment choices and priorities. The survey additionally assessed attitudes on physical function, psychosocial function, frequency of side effects and the potential for severe adverse events. Only those who completed the entire survey were included in the analysis. Those who completed the questionnaire in less than 5 minutes were excluded.
A total of 182 patients were included in the final analysis. In general, patient responses indicated that new patients prefer increased physical functional capacity with a reduced likelihood of severe adverse events. In addition, the researchers noted two prevailing patterns of preference from survey respondents — the chances of experiencing an adverse event and improvement of physical function.
“Patients with RA (<5 years) and inadequate response to first-line monotherapy have differing treatment preferences,” Bywall and colleagues wrote. “They focus mainly on increasing functional capacity or on the likelihood of getting a severe side effect. Therefore, communication in shared decision-making needs to account for heterogeneity in patient preferences in order to increase patient-centeredness in personalized precision medicine.”
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