What Matters Most to Patients and Rheumatologists? A Discrete Choice Experiment in Rheumatoid Arthritis.
Adv Ther
; 37(4): 1479-1495, 2020 04.
Article
en En
| MEDLINE
| ID: mdl-32088860
ABSTRACT
INTRODUCTION:
To determine patient and rheumatologist preferences for rheumatoid arthritis (RA) treatment attributes in Spain and to evaluate their attitude towards shared decision-making (SDM).METHODS:
Observational, descriptive, exploratory and cross-sectional study based on a discrete choice experiment (DCE). To identify the attributes and their levels, a literature review and two focus groups (patients [P] = 5; rheumatologists [R] = 4) were undertaken. Seven attributes with 2-4 levels were presented in eight scenarios. Attribute utility and relative importance (RI) were assessed using a conditional logit model. Patient preferences for SDM were assessed using an ad hoc questionnaire.RESULTS:
Ninety rheumatologists [52.2% women; mean years of experience 18.1 (SD 9.0); seeing an average of 24.4 RA patients/week (SD 15.3)] and 137 RA patients [mean age 47.5 years (SD 10.7); 84.0% women; mean time since diagnosis of RA 14.2 years (SD 11.8) and time in treatment 13.2 years (SD 11.2), mean HAQ score 1.2 (SD 0.7)] participated in the study. In terms of RI, rheumatologists and RA patients viewed time with optimal QoL R 23.41%/P 35.05%; substantial symptom improvement R 13.15%/P 3.62%; time to onset of treatment action R 16.24%/P 13.56%; severe adverse events R 10.89%/P 11.20%; mild adverse events R 4.16%/P 0.91%; mode of administration R 25.23%/P 25.00%; and added cost R 6.93%/P 10.66%. Nearly 73% of RA patients were involved in treatment decision-making to a greater or lesser extent; however, 27.4% did not participate at all.CONCLUSION:
Both for rheumatologists and patients, the top three decision-making drivers are time with optimal quality, treatment mode of administration and time to onset of action, although in different ranking order. Patients were willing to be more involved in the treatment decision-making process.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Relaciones Médico-Paciente
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Artritis Reumatoide
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Pautas de la Práctica en Medicina
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Prioridad del Paciente
/
Reumatólogos
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
País/Región como asunto:
Europa
Idioma:
En
Revista:
Adv Ther
Asunto de la revista:
TERAPEUTICA
Año:
2020
Tipo del documento:
Article
País de afiliación:
España