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 rheumatoid arthritis (RA) treatment, it is necessary to understand each RA patient’s satisfaction and to identify the factors affecting their satisfaction. Despite the rise in medical costs for RA, little is known about the factors that influence patient satisfaction with the cost of treatment in RA patients. Methods This is a multicenter observational study of Japanese RA patients from the FRANK Registry with data analyzed from March 2017 to August 2020. We collected data on demographic characteristics, clinical data, quality of life which was evaluated using the EuroQol 5-dimensional questionnaire (EQ5D), and patient satisfaction. The four categories of patient satisfaction were evaluated individually (i.e., cost, treatment efficacy, activities of daily living [ADL], and global treatment satisfaction). We analyzed the factors that affected each patient’s satisfaction, such as age, sex, EQ5D, disease duration, disease activity, and treatment. Results This study included 2235 RA outpatients (406 males, 1829 females). In RA patients, “very satisfied” and “satisfied” were given for nearly half of each satisfaction aspect (cost 49%; efficacy 72%; ADL 58%; global treatment 66%) at the time of the initial registration. To investigate the factors influencing each satisfaction, multivariate analysis has revealed that the use of b/tsDMARDs increased satisfaction of treatment effect (odds ratio [OR] 0.66) and ADL (OR 0.78) but decreased cost satisfaction (OR 2.21). Age (50–64 years; OR 0.91; 65–74 years, 0.55: ≥ 75 years, 0.35), female (OR 0.81), and history of musculoskeletal surgery (OR 0.60) all increased cost satisfaction. Patients with lower disease activity and higher EQ5D scores had higher levels of satisfaction in all areas. Conclusions In this study, patient satisfaction in terms of cost, treatment effect, ADL, and overall treatment was generally higher, but some patients were dissatisfied. The cost of satisfaction increased with age and a history of musculoskeletal surgery, while it decreased with a lower EQ5D score and the use of b/tsDMARDs.

Patient satisfaction with medication in rheumatoid arthritis: an unmet need

“…This result can be explained by the high costs of bDMARDs [ 16 ]. Indeed, a study carried out in Japan showed that the use of biological treatment was a predictive factor of dissatisfaction (OR = 2.21, p < 0.001) [ 24 ].…”

Need to assess the effect of therapy? Ask the patient!

“…Через 12 месяцев на фоне коррекции терапевтической схемы число удовлетворенных лечением пациентов достигло 85%, причем большинство из них составляли лица, исходно довольные назначенной терапией -отношение шансов (ОШ) -2,98 (95% ДИ: 2,58-3,44) [16]. Японский регистр FRANK, включавший данные 2235 пациентов с РА, показал значения «очень высокую удовлетворенность» и «удовлетворенность» (шкала 1-6) в отношении повседневной активности у 58%, проводимым лечением -у 72%, общим результатом терапии -у 66% респондентов [17]. Согласно недавно проведенному анонимному телефонному и интернет-опросу 882 больных РА в Испании, 56,8% опрошенных считали, что у них сохраняется высокая активность болезни, 31,5% отметили «эмоциональное неблагополучие», а 17,3% сообщили, что не удовлетворены проводимым лечением [18].…”

Dynamics of patient reported outcomes during the use various biological disease-modifying antirheumatic drugs for rheumatoid arthritis

“…Возможность достижения данного результата показывает, например, исследование T. Fujiwara и соавт. [9], которые наблюдали японскую когорту FRANK, включавшую 2235 пациентов с РА (2017-2020 гг.). На фоне активной терапии (72% больных получали МТ; 31% -ГИБП или тсБПВП; 40% -глюкокортикоиды) ремиссия или НВА по DAS28 были достигнуты в 81% случаев.…”