What Matters Most to Patients and Rheumatologists? A Discrete Choice Experiment in Rheumatoid Arthritis.

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From: Advances in Therapy(Vol. 37, Issue 4)
Publisher: Springer
Document Type: Report
Length: 397 words

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Keywords: Conjoint analysis; Discrete choice experiment; Patient perspective; Preferences; Rheumatoid arthritis; Rheumatologist perspective; Rheumatology; Share decision 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. Author Affiliation: (1) Hospital de la Santa Creu i Sant Pau, Barcelona, Spain (2) Hospital Can Misses, Ibiza, Spain (3) Hospital Universitario y Politécnico La Fe, Valencia, Spain (4) HO&RWE Department, Lilly, Spain (5) Medical Department, Lilly, Spain (6) Outcomes'10, Castellón de la Plana, Spain (7) Department of Medicine, Jaume I University, Castellón de la Plana, Spain (j) lizan@outcomes10.com Article History: Registration Date: 02/10/2020 Received Date: 01/16/2020 Online Date: 02/22/2020 Byline: Cesar Díaz-Torné (1), Ana Urruticoechea-Arana (2), José Ivorra-Cortés (3), Silvia Díaz (4), Tatiana Dilla (4), José Antonio Sacristán (5), José Inciarte-Mundo (5), Marta Comellas (6), Miriam Prades (6), Luis Lizán (corresponding author) (6, 7, j)

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Gale Document Number: GALE|A628275211