Factors Affecting Patient Satisfaction Related to Cost and Treatment Effectiveness in Rheumatoid Arthritis: Results From the Multicenter Observational Cohort Study, FRANK Registry

Abstract

Background. To further improve treatment for rheumatoid arthritis (RA), it is necessary to understand each RA patient satisfaction and to identify the factors affecting patient satisfaction. Despite of escalation of medical cost for RA, the affected factors of satisfaction for cost of treatment in RA patients has been little known.Methods. This is a multicenter observational study of RA patients at Fukuoka, Japan from the FRANK registry, and has been analyzed the initial registered data from March 2017 to August 2020. We collected data on demographic characteristics, clinical data, quality of life, which was assessed using the EuroQol 5-dimensional questionnaire (EQ5D), and patient satisfaction. Patient satisfaction was individually assessed by the four categories (i.e., cost, treatment efficacy, activities of daily living [ADL], and global treatment satisfaction). We analyzed the factors affected with each patient satisfaction, such as age, sex, EQ5D, disease duration, disease activity, and treatment.Results. This study included 2,235 RA outpatients (406 males, 1829 females). At the initial registration, “Very satisfied” and “Satisfied” were given for almost half of each satisfaction aspect (cost: 49%; effecacy: 72%; ADL: 58%; global treatment: 66%) in RA patients. To investigate the affected factors for each satisfaction, multivariate analysis has revealed that the use of b/tsDMARDs increased satisfaction of treatment effect (odds ratio [OR] 0.67) and ADL (OR 0.79), but decreased cost satisfaction (OR 2.24). Aging (50-64 years: OR 0.90, 65-74 years: 0.56, ≥75 years: 0.36), female (OR 0.80), and history of musculoskeletal surgery (OR 0.60) increased cost satisfaction. All aspects of patient satisfaction were elevated in those with lower disease activity and higher score of EQ5D. Conclusions. Patient satisfaction in terms of cost, treatment effect, ADL, and global treatment was generally better in this study, but still remained some patient with unsatisfaction. Cost of satisfaction was increased with aging and having the history of musculoskeletal surgery, and decreased in lower EQ5D score, and the use of b/tsDMARDs.