Patients' perceptions on shared decision making during prescription of subcutaneous biological drug treatments for inflammatory arthritis: The RHEU‐LIFE survey

Abstract

Objectives: The aim of this study was to explore the preferences of patients with rheumatic diseases and their perceived experience regarding participation in shared decision making (SDM) when they were prescribed a subcutaneous (SC) biological drug. Methods: A printed survey was handed to 1,000 patients with inflammatory rheumatic diseases treated with SC biological drug. The survey included closed questions about preferences regarding decision making and about patients' experience when they were prescribed an SC biological drug. Descriptive statistics were performed with stratification by patient profiles, using chi-square for comparisons between groups. Results: A total of 592 surveys were received (response rate 59.2%, mean age 51.7 years, 57.6% women). Some 28.2% of patients reported preferring to take part in treatment selection, a percentage that was higher in younger patients, in those with higher academic degree and in those who search information in sources different to that of health care professionals. Over half of patients (56.3%) perceived that the rheumatologist considered their opinion when prescribing an SC biological drug, a percentage higher in younger people. Only in 40.8% of cases did the patients' preference match their perception of their participation in the process. No differences were observed by sex, disease or number of biologics. Conclusions: Patients with inflammatory rheumatic diseases want information about their treatments but mostly leave the prescription decision to the rheumatologist. Younger people, or those with higher academic degree, more often want to participate in the SDM. There are discrepancies between patient preferences and perceptions of this process.

One year in review 2021: novelties in the treatment of rheumatoid arthritis

“…Oral route of administration was preferred over parenteral one, with daily frequency partially counterbalancing such effect. In a Spanish study, about a third of RA patients reported willingness to enter the treatment decision process at the time of the choice of biological (b)DMARDs, in a so-called 'shared decision' approach, although the majority of patients delegated this decision to the rheumatologist (9). Nonetheless, how to operationalise shared decisions in inflammatory arthritis and whether such approach might be favourable in terms of disease outcome along with better care experience is still matter of debate.…”

“…• The most recent data regarding the global health of RA population indicate that, despite the extensive scientific knowledge on the treatment of RA, the translation of these into the community of patients with RA has not yet took place (2-5) . • The urgency of the emerging treatment of RA, rather than the availability of new drugs, appears to be to design and implement new treatment delivery strategies, with the involvement of patients to complete this process (6)(7)(8)(9)(10).…”