Core Outcome Sets Specifically for Longterm Observational Studies: OMERACT Special Interest Group Update in Rheumatoid Arthritis

López-Olivo, María A.; Negrón, José B.; Zogala, Richard J; Carmona, Loreto; Criner, Karla; Goel, Niti; González-López, Laura; Ingegnoli, Francesca; Leong, Amye; March, Lyn; Shea, Beverly; Strand, Vibeke; Tugwell, Peter; Westrich-Robertson, Tiffany; Zamora, Natalia; Christensen, Robin; Suarez‐Almazor, María E.

doi:10.3899/jrheum.181076

Cited by 8 publications

(4 citation statements)

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“…Those authors found that primary studies of interventions for RA patients generally reported insufficient variables necessary to address questions about health inequalities. Similarly, it was noted by an Outcome Measures in Rheumatology (OMERACT) special interest group in 2019 that few longitudinal RA outcome studies or registries report sufficient collection of variables to determine SES ( 72 ).…”

Section: Discussionmentioning

confidence: 99%

Socioeconomic Status and Medication Use in Rheumatoid Arthritis: A Scoping Review

Russell

Lester

Black

et al. 2022

Arthritis Care & Research

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Objective Socioeconomic status (SES) influences disease outcomes in rheumatoid arthritis (RA) patients. Differences in medication use may partly explain this association. A scoping review was used to identify research conducted on this topic and determine what knowledge gaps remain. Methods Medline, Embase, and PsychInfo were searched from their inception until February 2022 for studies that assessed SES and medication use as an outcome variable. Data was extracted on the use of specific SES measures, medication use, and whether differences in SES variables were associated with differences in medication use. Results We identified 2,103 studies, of which 81 were selected for inclusion. Included studies originated most frequently from the US (42%); the mean ± SD age of participants was 55.9 ± 6.8 years, and most were female (75%). Studies measured a median of 4 SES variables (interquartile range 3–6), with educational, area‐level SES, and income being the most frequent measurements used. Patients' race and/or ethnicity were documented by 34 studies. Studies primarily assessed the likelihood of prescription of disease‐modifying antirheumatic drugs or dispensation, medication adherence, or treatment delays. A majority of studies documented at least 1 SES measure associated with a difference in medication use. Conclusion There is some evidence that SES affects use of medications in patients with RA; however, multiple definitions of SES have been utilized, making comparisons between studies difficult. Prospective studies with consistently defined SES will be needed to determine whether differences in medication use accounts for the poorer outcomes experienced by patients of lower SES.

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Section: Discussionmentioning

confidence: 99%

Socioeconomic Status and Medication Use in Rheumatoid Arthritis: A Scoping Review

Russell

Lester

Black

et al. 2022

Arthritis Care & Research

View full text Add to dashboard Cite

show abstract

“…This could reflect the health system in Spain, with universal coverage of visits, admissions and medications, highly accessible in all the territories of Spain. In countries with other types of health systems, with no universal coverage or high payment for health services, economic factors may impact directly adherence and are a source of long-term concern, even for health 36. Another socioeconomic aspect could be work-related problems due to scheduled visits or due to the medication having been administered in-hospital.…”

Section: Discussionmentioning

confidence: 99%

Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study

2021

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Non-adherence challenges efficacy and costs of healthcare. Knowledge of the underlying factors is essential to design effective intervention strategies.ObjectivesTo estimate the prevalence of treatment adherence in rheumatoid arthritis (RA) and to evaluate its predictors.MethodsA 6-month prospective cohort study of patients with RA selected by systematic stratified sampling (33% on first disease-modifying rheumatic drug (DMARD), 33% on second-line DMARD and 33% on biologics). The outcome measure was treatment adherence, defined by a score greater than 80% both in the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale, and was estimated with 95% CIs. Predictive factors included sociodemographic, psychological, clinical, drug-related, patient–doctor relationship related and logistic. Their effect on 6-month adherence was examined by multilevel logistic models adjusted for baseline covariates.Results180 patients were recruited (77% women, mean age 60.8). The prevalence of adherence was 59.1% (95% CI 48.1% to 71.8%). Patients on biologics showed higher adherence and perceived a higher medication need than the others; patients on second-line DMARDs had experienced more adverse events than the others. The variables explaining adherence in the final multivariate model were the type of treatment prescribed (second-line DMARDs OR=5.22, and biologics OR=3.76), agreement on treatment (OR=4.57), having received information on treatment adaptation (OR=1.42) and the physician perception of patient trust (OR=1.58). These effects were independent of disease activity.ConclusionTreatment adherence in RA is far from complete. Psychological, communicational and logistic factors influence treatment adherence in RA to a greater extent than sociodemographic or clinical factors.

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“… 3 While designed to improve the reporting of clinical trial outcomes and enable evidence synthesis, COS are increasingly being used in other types of research including observational studies. 5 , 6 COS could also provide a rigorous and transparent approach to prioritizing and selecting outcomes for life course cohorts planning to embed capabilities for trials.…”

Section: Introductionmentioning

confidence: 99%

Synthesizing Core Outcome Sets for outcomes research in cohort studies: a systematic review

et al. 2021

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Background Life course studies are designed to “collect once, use multiple times” for observational and, increasingly, interventional research. Core Outcome Sets (COS) are minimum sets developed for clinical trials by multi-stakeholder consensus methodologies. We aimed to synthesize published COS that might guide outcomes selection for early life cohorts with an interventional focus. Methods We searched PubMed, Medline, COMET, and CROWN for COS published before January 2021 relevant to four life stages (pregnancy, newborns, children <8 years, and parents (adults aged 18–50 years)). We synthesized core outcomes into overarching constructs. Results From 46 COS we synthesized 414 core outcomes into 118 constructs. “Quality of life”, “adverse events”, “medication use”, “hospitalization”, and “mortality” were consistent across all stages. For pregnancy, common constructs included “preterm birth”, “delivery mode”, “pre-eclampsia”, “gestational weight gain”, “gestational diabetes”, and “hemorrhage”; for newborns, “birthweight”, “small for gestational age”, “neurological damage”, and “morbidity” and “infection/sepsis”; for pediatrics, “pain”, “gastrointestinal morbidity”, “growth/weight”, “breastfeeding”, “feeding problems”, “hearing”, “neurodevelopmental morbidity”, and “social development”; and for adults, “disease burden”, “mental health”, “neurological function/stroke”, and “cardiovascular health/morbidity”. Conclusion This COS synthesis generated outcome constructs that are of high value to stakeholders (participants, health providers, services), relevant to life course research, and could position cohorts for trial capabilities. Impact We synthesized existing Core Outcome Sets as a transparent methodology that could prioritize outcomes for lifecourse cohorts with an interventional focus. “Quality of life”, “adverse events”, “medication use”, “hospitalization”, and “mortality” are important outcomes across pregnancy, newborns, childhood, and early-to-mid-adulthood (the age range relevant to parents). Other common outcomes (such as “birthweight”, “cognitive function/ability”, “psychological health”) are also highly relevant to lifecourse research. This synthesis could assist new early life cohorts to pre-select outcomes that are of high value to stakeholders (participants, health providers, services), are relevant to lifecourse research, and could position them for future trials and interventional capability.

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Core Outcome Sets Specifically for Longterm Observational Studies: OMERACT Special Interest Group Update in Rheumatoid Arthritis

Cited by 8 publications

References 4 publications

Socioeconomic Status and Medication Use in Rheumatoid Arthritis: A Scoping Review

Socioeconomic Status and Medication Use in Rheumatoid Arthritis: A Scoping Review

Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study

Synthesizing Core Outcome Sets for outcomes research in cohort studies: a systematic review

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