Although most patients with rheumatoid arthritis (RA) are satisfied with their prescribed treatment, many would like to change various aspects of their medication, according to the results of an online patient survey.
Specifically, 7 of 10 survey respondents desired fewer medications, and approximately 50% wanted more choices. In addition, noncompliance with medication was high.
The survey was designed by an advisory panel comprised of RA medical experts and patient group leaders from 17 countries, and was commissioned by Pfizer in the United States. Results were recently presented at the 9th Rheumatology Nurses Society Annual Conference.
A total of 3649 patients with RA from 13 countries responded to the survey. Approximately half (48%) of the respondents said that having a dialogue with the healthcare professional managing their RA would help them to manage their disease more successfully. Interestingly, 62% responded that they felt uncomfortable raising their concerns or fears with their physician or healthcare professional.
“In addition to revealing disconnects between patients and physicians across multiple aspects of RA disease management, our survey also showed that physicians may need to do a better job of helping their patients set goals and communicate openly,” said Eustratios Bananis, PhD, Medical Director for Inflammation, Pfizer, and co-investigator of the data presented at the conference.
Most often, patients defined successful treatment as a reduction in pain or joint swelling/inflammation (81%) and improvement in health-related quality of life (77%). This definition differs from the current treatment goal for physicians, which is to achieve a state of clinical remission—or at least low disease activity—as determined by composite measures that include joint counts.
Globally, 38% of respondents were not taking their RA medications exactly as prescribed, including 31% of US patients. “This was due to a multitude of factors, including their concern about potential side effects, issues with administration, or the general inconvenience of taking them,” Dr Bananis explained.
Thirty-five percent of the respondents cited the number or frequency of medications as the aspect of their prescribed medication that they would most like to change. A similar percentage (34%) cited treatment-related side effects as the aspect of their treatment they most wanted to change. Globally, 70% of patients expressed a wish for fewer RA medications, and 57% were worried that their medication would fail.
Approximately 89% of US patients had goals for managing their RA, from reducing their joint pain to quality-of- life goals (eg, increasing their level of physical activity). However, only 21% of US patients had actually set treatment goals for their RA with their physician. “This suggests that despite having a belief in the importance of setting goals, there may be a gap between belief and practice,” said Dr Bananis. “This is one reason that improving the patient−physician dialogue may help in goal setting and overall disease management.”
Increasing healthcare professionals’ awareness of patient concerns may encourage them to ask more follow-up questions when assessing disease activity status, and when setting goals for treatment. “Treatment goals for healthcare professionals and patients in managing RA can be different; not acknowledging these differences may lead to low healthcare professional and patient satisfaction, and poor patient compliance with therapy,” Dr Bananis concluded. A similar survey from the perspective of rheumatologists is underway.