Pop a pill or give myself a shot? Patient perspectives of disease-modifying anti-rheumatic drug choice for rheumatoid arthritis - 11/02/21
, Haley Tornberg d, Susan M. Goodman dBienvenue sur EM-consulte, la référence des professionnels de santé.
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Highlights |
• | This study provides the patient perspective regarding the reasons for choice between oral versus injectable DMARD. |
• | Efficacy/effectiveness, side effects/fear of side effects and cost were the main reasons for choice of oral versus injectable DMARD for RA. |
Abstract |
Objective |
To assess how patients with rheumatoid arthritis (RA) decide whether to add oral disease-modifying anti-rheumatic drugs (DMARDs) versus injectable biologic DMARDs when methotrexate response is inadequate.
Methods |
Using nominal group technique (NGT), RA patients answered the question “What sort of things are important to you when you make a decision between adding pills versus injectable medications to treat rheumatoid arthritis when methotrexate fails to control RA disease activity?” Patients nominated, discussed, and voted for the responses.
Results |
Forty-seven RA patients participated: Birmingham (n=6 NG; 21 patients) and New York City (n=4 NG; 26 patients). They were predominantly female (85%), 70% white, with a mean age of 64.5 years and 58% had>10-year RA duration. Present/past DMARDs included methotrexate only in 6%, other traditional DMARDs in 15%, glucocorticoids in combination with traditional DMARDs in 11%, and biologics and/or Jak-kinase inhibitors in 68% of participants. Voted domains in order were: (1) efficacy/effectiveness and the onset/mode of action (78/282 votes); (2) side effects/fear of side effects (84/282 votes); (3) cost including out of pocket, co-payments and patient responsibility (54/282 votes); (4) convenience/frequency of use (27/282 votes); (5) doctor's opinion (20/282 votes); (6) other drugs/comorbidity/other patient's experience/effects on other people (3/282 votes); (7) fear of needles (8/282 votes); and (8) newness of the medication (8/282 votes).
Conclusions |
We identified the patient perspective regarding the choice between adding oral versus injectable DMARD once methotrexate failed to control RA disease activity. This knowledge can help in shared decision-making for DMARD choice in RA treatment.
Le texte complet de cet article est disponible en PDF.Keywords : Rheumatoid arthritis, Treatment, Nominal group, Disease-modifying anti-rheumatic drug, DMARD, Oral conventional, Biologic, Injectable, Patient perspective, Qualitative
Plan
Vol 88 - N° 1
Article 105053- janvier 2021 Retour au numéro
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