Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis

Fraenkel, Liana; Nowell, W. Benjamin; Michel, George; Wiedmeyer, Carole

doi:10.1136/annrheumdis-2017-212407

Cited by 43 publications

(68 citation statements)

References 18 publications

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“…We sought to address this gap by using a value clarification tool that enabled patients to potentially match with 1 or more of 5 distinct phenotypes describing treatment preferences, thus enabling patients to view how other patients’ values vary, and to match, rather than construct, preferences. The former is a more rapid cognitive task that may be better suited to decision‐making at the point‐of‐care .…”

Section: Discussionmentioning

confidence: 99%

“…The members of the largest group (38.4%) were affected most by the cost of medications, members of the second largest group (25.8%) were concerned about the risk of bothersome side effects, and members of the third largest group (18%) were most impacted by the onset of action and risk of serious infections. The 2 smallest groups were most concerned about the risk of very rare side effects (11.2%) and the route of administration (6.6%) . Generation of the phenotypes is discussed elsewhere .…”

Section: Methodsmentioning

confidence: 99%

“…The 2 smallest groups were most concerned about the risk of very rare side effects (11.2%) and the route of administration (6.6%) . Generation of the phenotypes is discussed elsewhere . We (CW and LF) subsequently developed an initial prototype of the value clarification tool to illustrate the set of preferences using lay terminology and familiar concepts (e.g., a star rating system).…”

Section: Methodsmentioning

confidence: 99%

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Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study

Hsiao

Binder-Finnema

Nowell

et al. 2019

Arthritis Care & Research

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study

Hsiao

Binder-Finnema

Nowell

et al. 2019

Arthritis Care & Research

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“…Information about patient preferences has long been considered important for supporting patient-centeredness in clinical decisions [1]. Over the past decade, measuring patient preferences has evolved to use methods that quantify preferences in the clinical context [2][3][4][5]. Today, rheumatology uses quantitative assessment of patient preferences to inform clinical decisions [6].…”

Section: Introductionmentioning

confidence: 99%

Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

Bywall¹,

Kihlbom²,

Hansson³

et al. 2020

Preprint

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Background Preference assessments of patients with rheumatoid arthritis (RA) help inform clinical therapeutic decisions for including biologic and targeted synthetic drugs to use. This study assesses patient preferences for biologics or Janus kinases (JAK) inhibitors and heterogeneity within these preferences to estimate the relative importance of treatment characteristics and to calculate the minimum benefit levels patients require to accept higher levels of side effects. Methods Between November 2018 to August 2019, patients were recruited to participate in a survey containing demographic and disease-related questions as well as a Discrete Choice Experiment to measure their preferences for second-line therapies using biologics or JAK inhibitors. Treatment characteristics (attributes) included in the DCE were mode of administration, frequency of use, probability of mild short-term side effects, probability of side effects affecting appearance, probability of psychological side effects, probability of severe side effects, and effectiveness of treatment. Results A total of 358 patients were included in the analysis. Latent class analysis revealed three preference patterns. When choosing treatment, the respondents found either effectiveness of treatment, mode of administration, or probability of severe side effects as most important. In addition, disease duration and mild side effects influenced the patients’ choices. Conclusion Respondents found either effectiveness, severe side effects, or mode of administration as the most important attribute. Patients noting effectiveness as most important were more willing than other patients to accept higher risks of side effects.

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“…Treatment of RA should be based on a shared decision between the patient and the rheumatologist. SoR: A; QoE: D Shared decision-making is important for the success of treat-to-target strategies in RA [24]. Patients should be informed on all aspects of RA and its management, including the risks and benefits of individual treatments, and be involved in the development of a treatment plan to reach an agreed therapeutic target [10,25].…”

mentioning

confidence: 99%

Management of rheumatoid arthritis: 2019 updated consensus recommendations from the Hong Kong Society of Rheumatology

Mok

Cheung

et al. 2019

Clin Rheumatol

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The expanding range of treatment options for rheumatoid arthritis (RA), from conventional synthetic disease-modifying antirheumatic drugs (DMARDs) to biological DMARDs (bDMARDs), biosimilar bDMARDs, and targeted synthetic DMARDs, has improved patient outcomes but increased the complexity of treatment decisions. These updated consensus recommendations from the Hong Kong Society of Rheumatology provide guidance on the management of RA, with a focus on how to integrate newly available DMARDs into clinical practice. The recommendations were developed based on evidence from the literature along with local expert opinion. Early diagnosis of RA and prompt initiation of effective therapy remain crucial and we suggest a treat-to-target approach to guide optimal sequencing of DMARDs in RA patients to achieve tight disease control. Newly available DMARDs are incorporated in the treatment algorithm, resulting in a greater range of second-line treatment options. In the event of treatment failure or intolerance, switching to another DMARD with a similar or different mode of action may be considered. Given the variety of available treatments and the heterogeneity of patients with RA, treatment decisions should be tailored to the individual patient taking into consideration prognostic factors, medical comorbidities, drug safety, cost of treatment, and patient preference.

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Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis

Abstract: Treatment preferences of patients with RA can be measured and represented by distinct phenotypes. Our results underscore the variability in patients' values and the importance of using a shared decision-making approach to implement TTT.

Cited by 43 publications

References 18 publications

Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study

Preference Phenotypes in Support of Shared Decision–Making at Point‐of‐Care for Patients With Rheumatoid Arthritis: A Proof‐of‐Concept Study

Patient preferences on rheumatoid arthritis second-line treatment: A discrete choice experiment of Swedish patients

Management of rheumatoid arthritis: 2019 updated consensus recommendations from the Hong Kong Society of Rheumatology

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