Are Health Care Professionals’ Implicit and Explicit Attitudes Toward Conventional Disease‐Modifying Antirheumatic Drugs Associated With Those of Their Patients?

Abstract

Objective It is generally unknown how the attitudes and beliefs of health care professionals (HCPs) might affect the attitudes, beliefs, and medication‐taking behavior of patients with rheumatoid arthritis (RA). This study aims 1) to examine the attitudes, health‐related associations (both implicit and explicit), and beliefs of HCPs about conventional disease‐modifying antirheumatic drugs, and 2) to assess whether these attitudes, health‐related associations, and beliefs of HCPs are associated with those of their patients, with their patients’ medication‐taking behavior, and disease activity. Methods HCPs were recruited from 2 centers that specialized in rheumatology across The Netherlands, and patient recruitment followed. In this observational study, implicit outcomes were measured with single‐category implicit association tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs About Medicines Questionnaire–Specific. Spearman’s rank correlations were used to describe correlations between implicit and explicit measures of the attitudes of HCPs. Multilevel, mixed‐effects linear models were used to examine the association of HCP‐related characteristics, including the implicit and explicit outcomes of HCPs, with those of their patients, their medication‐taking behaviors, and disease activity. Results Of the 1,659 initially invited patients, 254 patients with RA (mean age 62.8 years, mean disease duration 11.8 years, and 68.1% of the patients were female) who were treated by 26 different HCPs agreed to participate in this study. The characteristics, attitudes, health‐related associations, and beliefs about medicines of HCPs were not significantly associated with those of their patients, nor with their medication‐taking behaviors or disease activity scores. Conclusion This study demonstrated that the attitudes, health‐related associations (as measured both implicitly and explicitly), and beliefs of HCPs were not significantly associated with the attitudes, beliefs, medication‐taking behavior, and disease activity of patients with RA.

Beliefs of rheumatologists and general practitioners on urate lowering therapy: a cross-sectional study

“…We found no associations between physicians’ medication beliefs and their prescribed dosage of allopurinol, gout outcomes or the medication beliefs of patients. This is in line with earlier research in rheumatology [ 19 ]. Of note, in our unadjusted model, a higher concern score was associated with a lower prescribed dosage of allopurinol.…”

“…In line with other studies, we found that physicians reported a greater need and fewer concerns for their prescribed medication [ 19–21 ]. The average necessity score falls in the range of previous studies regarding beliefs regarding statins and DMARDs (13.9–20.9) [ 19–21 ].…”

“…In line with other studies, we found that physicians reported a greater need and fewer concerns for their prescribed medication [ 19–21 ]. The average necessity score falls in the range of previous studies regarding beliefs regarding statins and DMARDs (13.9–20.9) [ 19–21 ]. The average concern score of rheumatologists, however, is slightly lower than the range of previous studies of prescribing DMARDs and statins (11.5–13.5) [ 19–21 ].…”

“…The average necessity score falls in the range of previous studies regarding beliefs regarding statins and DMARDs (13.9–20.9) [ 19–21 ]. The average concern score of rheumatologists, however, is slightly lower than the range of previous studies of prescribing DMARDs and statins (11.5–13.5) [ 19–21 ]. A plausible explanation for this is that ULT is relatively safe and well tolerated [ 2 ].…”

“…Empirical findings about the relations between physicians’ medication beliefs, clinical management and patients’ beliefs and outcomes are scarce and inconclusive [ 19–24 ].…”