Patient Expectations and Perceptions of Goal-setting Strategies for Disease Management in Rheumatoid Arthritis

Abstract

Objective.To identify how patients perceive the broad effect of active rheumatoid arthritis (RA) on their daily lives and indicate how RA disease management could benefit from the inclusion of individual goal-setting strategies.Methods.Two multinational surveys were completed by patients with RA. The “Good Days Fast” survey was conducted to explore the effect of disease on the daily lives and relationships of women with RA. The “Getting to Your Destination Faster” survey examined RA patients’ treatment expectations and goal-setting practices.Results.Respondents from all countries agreed that RA had a substantial negative effect on many aspects of their lives (work productivity, daily routines, participation in social and leisure activities) and emotional well-being (loss of self-confidence, feelings of detachment, isolation). Daily pain was a paramount issue, and being pain- and fatigue-free was considered the main indicator of a “good day.” Setting personal, social, and treatment goals, as well as monitoring disease progress to achieve these, was considered very beneficial by patients with RA, but discussion of treatment goals seldom appeared to be a part of medical appointments.Conclusion.Many patients with RA feel unable to communicate their disease burden and treatment goals, which are critically important to them, to their healthcare provider (HCP). Insights gained from these 2 surveys should help to guide patients and HCP to better focus upon mutually defined goals for continued improvement of management and achievement of optimal care in RA.

Impact of intensive treatment and remission on health-related quality of life in early and established rheumatoid arthritis

“…32 The 'Good Days Fast' and 'Getting to Your Destination Faster' surveys found most patients rated 'having a good day' as their preferred target for RA management; being free of fatigue and pain often characterised 'good days'. 33 In these surveys, pain was a prevalent problem for patients with RA. Our findings suggest that attaining remission, though crucial to improving RA outcomes, is insufficient by itself to entirely normalise HRQoL in active RA, particularly in established disease.…”

High Disease Activity May Increase Fear-Avoidance Beliefs in Rheumatoid Arthritis

“…30 Consequently, pain education 31 in patients with RA may provide an effective strategy to manage FA and related disability in RA patients, improving treatment outcomes. Furthermore, as FA beliefs originate from cognitive-behavior accounts, physician-patient communication that centralizes the impact of RA on quality of life 32 and guides the treatment according to patients' expectations and perceptions 33 may also help to combat against FA beliefs.…”

Examination of Patient-Reported Outcomes in Association with TNF-Inhibitor Treatment Response: Results from a US Observational Cohort Study

“…Despite the availability of biologic disease-modifying antirheumatic drugs (bDMARDs), the literature suggests that many patients with RA continue to experience moderate or even unacceptable levels of pain [2]. One potential contributing factor is that patients are often reluctant to discuss issues of personal importance, such as pain, fatigue, or their ability to function and participate in activities, with their physician [3].…”

“…Implementation of a treatto-target strategy may be challenging when the patient and physician have different goals. Although rheumatologists may suggest adjustments in medications to achieve a composite index disease activity target, this may not have meaning for the patient; rather, patients often prioritize reduction of pain and improvement in function as their goals of therapy [1,3].…”