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Published in: Rheumatology and Therapy 3/2019

Open Access 01-09-2019 | Rheumatoid Arthritis | Original Research

Patient Perceptions of Unmet Medical Need in Rheumatoid Arthritis: A Cross-Sectional Survey in the USA

Authors: Christine Radawski, Mark C. Genovese, Brett Hauber, W. Benjamin Nowell, Kelly Hollis, Carol L. Gaich, Amy M. DeLozier, Kelly Gavigan, Maria Reynolds, Anabela Cardoso, Jeffrey R. Curtis

Published in: Rheumatology and Therapy | Issue 3/2019

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Abstract

Introduction

Many rheumatoid arthritis (RA) patients do not achieve their treatment goals and experience symptoms that affect psychosocial outcomes and daily activities. This study aimed to identify and quantify the unmet needs perceived by US patients with RA currently taking a disease-modifying antirheumatic drug (DMARD).

Methods

A cross-sectional, web-based survey was conducted with RA patients recruited through CreakyJoints, an online patient support community, and ArthritisPower®, an online patient research registry, from December 2017 to January 2018. Participant patients were aged ≥ 21 years, failed ≥ 1 DMARDs, and were receiving their current DMARD(s) for ≥ 6 months; they answered 50 questions about treatment history, RA symptoms, and flares and completed the Rheumatoid Arthritis Impact of Disease (RAID) questionnaire and the Treatment Satisfaction Questionnaire for Medication (TSQM). Treatment satisfaction was defined by a TSQM global satisfaction score ≥ 80.

Results

Of 415 patients screened, 258 (62%) were eligible and completed the survey; 87% were women, and 87% white, with mean (SD) age of 54.5 (11.4) years. A total of 232 patients (90%) had current or past biologic DMARD (bDMARD) use, with 67% currently on a bDMARD, 65% on ≥ 1 conventional synthetic DMARD, and 40% on methotrexate. Forty-three percent of patients reported daily/almost daily use of prescription pain medications, and 44% reported a current flare. Mean (SD) TSQM scores were 59 [20] for effectiveness, 59 [26] for side effects, 72 [18] for convenience, and 65 [21] for global satisfaction. The mean (SD) RAID overall score was 5.1 (2.0) on a 0–10 scale. Only 26% (67 patients) were satisfied with their RA treatment. Patients not satisfied with treatment reported higher RAID scores overall and by domain, and approximately half reported a current flare.

Conclusions

Results from this real-world survey suggest that three-fourths of RA patients are not satisfied with treatments, which include bDMARDs. Patients continued to experience bothersome symptoms that impacted their daily activities and life. There remains a need for improved disease management among currently treated RA patients.

Funding

Eli Lilly and Company (Indianapolis, IN, USA).
Appendix
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Literature
1.
go back to reference Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016;68:1–26.CrossRefPubMed Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2016;68:1–26.CrossRefPubMed
2.
go back to reference Smolen JS, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. Nat Rev Rheumatol. 2015;11:276–89.CrossRefPubMed Smolen JS, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. Nat Rev Rheumatol. 2015;11:276–89.CrossRefPubMed
3.
go back to reference Smolen JS, Landewe R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73:492–509.CrossRefPubMed Smolen JS, Landewe R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis. 2014;73:492–509.CrossRefPubMed
4.
go back to reference Taylor PC, Moore A, Vasilescu R, Alvir J, Tarallo M. A structured literature review of the burden of illness and unmet needs in patients with rheumatoid arthritis: a current perspective. Rheumatol Int. 2016;36:685–95.CrossRefPubMedPubMedCentral Taylor PC, Moore A, Vasilescu R, Alvir J, Tarallo M. A structured literature review of the burden of illness and unmet needs in patients with rheumatoid arthritis: a current perspective. Rheumatol Int. 2016;36:685–95.CrossRefPubMedPubMedCentral
5.
go back to reference Strand V, Wright GC, Bergman MJ, Tambiah J, Taylor PC. Patient expectations and perceptions of goal-setting strategies for disease management in rheumatoid arthritis. J Rheumatol. 2015;42:2046–54.CrossRefPubMed Strand V, Wright GC, Bergman MJ, Tambiah J, Taylor PC. Patient expectations and perceptions of goal-setting strategies for disease management in rheumatoid arthritis. J Rheumatol. 2015;42:2046–54.CrossRefPubMed
6.
go back to reference Fraenkel L, Nowell WB, Michel G, Wiedmeyer C. Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis. Ann Rheum Dis. 2018;77:678–83.CrossRefPubMed Fraenkel L, Nowell WB, Michel G, Wiedmeyer C. Preference phenotypes to facilitate shared decision-making in rheumatoid arthritis. Ann Rheum Dis. 2018;77:678–83.CrossRefPubMed
7.
go back to reference Funahashi K, Matsubara T. What RA patients expect of their treatment—discussion over the result of our survey. Clin Rheumatol. 2012;31:1559–66.CrossRefPubMed Funahashi K, Matsubara T. What RA patients expect of their treatment—discussion over the result of our survey. Clin Rheumatol. 2012;31:1559–66.CrossRefPubMed
8.
go back to reference Gonzalez CM, Carmona L, de Toro J, et al. Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products. Patient Prefer Adherence. 2017;11:1243–52.CrossRefPubMedPubMedCentral Gonzalez CM, Carmona L, de Toro J, et al. Perceptions of patients with rheumatic diseases on the impact on daily life and satisfaction with their medications: RHEU-LIFE, a survey to patients treated with subcutaneous biological products. Patient Prefer Adherence. 2017;11:1243–52.CrossRefPubMedPubMedCentral
9.
go back to reference Poulos C, Hauber AB, Gonzalez JM, Turpcu A. Patients’ willingness to trade off between the duration and frequency of rheumatoid arthritis treatments. Arthritis Care Res. 2014;66:1008–15.CrossRef Poulos C, Hauber AB, Gonzalez JM, Turpcu A. Patients’ willingness to trade off between the duration and frequency of rheumatoid arthritis treatments. Arthritis Care Res. 2014;66:1008–15.CrossRef
10.
go back to reference Takahashi N, Sasaki K, Nishiyama T, Naniwa T. Satisfaction and attitudes toward therapy in patients with rheumatoid arthritis. Mod Rheumatol. 2012;22:376–81.CrossRefPubMed Takahashi N, Sasaki K, Nishiyama T, Naniwa T. Satisfaction and attitudes toward therapy in patients with rheumatoid arthritis. Mod Rheumatol. 2012;22:376–81.CrossRefPubMed
11.
go back to reference Wolfe F, Michaud K. Assessment of pain in rheumatoid arthritis: minimal clinically significant difference, predictors, and the effect of anti-tumor necrosis factor therapy. J Rheumatol. 2007;34:1674–83.PubMed Wolfe F, Michaud K. Assessment of pain in rheumatoid arthritis: minimal clinically significant difference, predictors, and the effect of anti-tumor necrosis factor therapy. J Rheumatol. 2007;34:1674–83.PubMed
12.
go back to reference Atkinson MJ, Kumar R, Cappelleri JC, Hass SL. Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM version II) among outpatient pharmacy consumers. Value Health. 2005;8(Suppl 1):S9–24.CrossRefPubMed Atkinson MJ, Kumar R, Cappelleri JC, Hass SL. Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM version II) among outpatient pharmacy consumers. Value Health. 2005;8(Suppl 1):S9–24.CrossRefPubMed
13.
go back to reference Atkinson MJ, Sinha A, Hass SL, et al. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;2:12.CrossRefPubMedPubMedCentral Atkinson MJ, Sinha A, Hass SL, et al. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;2:12.CrossRefPubMedPubMedCentral
14.
go back to reference Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009;7:36.CrossRefPubMedPubMedCentral Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009;7:36.CrossRefPubMedPubMedCentral
15.
go back to reference Reynolds K, Viswanathan HN, O’Malley CD, et al. Psychometric properties of the Osteoporosis-specific Morisky Medication Adherence Scale in postmenopausal women with osteoporosis newly treated with bisphosphonates. Ann Pharmacother. 2012;46:659–70.CrossRefPubMed Reynolds K, Viswanathan HN, O’Malley CD, et al. Psychometric properties of the Osteoporosis-specific Morisky Medication Adherence Scale in postmenopausal women with osteoporosis newly treated with bisphosphonates. Ann Pharmacother. 2012;46:659–70.CrossRefPubMed
16.
go back to reference Gossec L, Dougados M, Rincheval N, et al. Elaboration of the preliminary Rheumatoid Arthritis Impact of Disease (RAID) score: a EULAR initiative. Ann Rheum Dis. 2009;68:1680–5.CrossRefPubMed Gossec L, Dougados M, Rincheval N, et al. Elaboration of the preliminary Rheumatoid Arthritis Impact of Disease (RAID) score: a EULAR initiative. Ann Rheum Dis. 2009;68:1680–5.CrossRefPubMed
17.
go back to reference Dougados M, Brault Y, Logeart I, van der Heijde D, Gossec L, Kvien T. Defining cut-off values for disease activity states and improvement scores for patient-reported outcomes: the example of the Rheumatoid Arthritis Impact of Disease (RAID). Arthritis Res Ther. 2012;14:R129.CrossRefPubMedPubMedCentral Dougados M, Brault Y, Logeart I, van der Heijde D, Gossec L, Kvien T. Defining cut-off values for disease activity states and improvement scores for patient-reported outcomes: the example of the Rheumatoid Arthritis Impact of Disease (RAID). Arthritis Res Ther. 2012;14:R129.CrossRefPubMedPubMedCentral
18.
go back to reference Salaffi F, Di Carlo M, Vojinovic J, et al. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis. Jt Bone Spine. 2018;85:317–22.CrossRef Salaffi F, Di Carlo M, Vojinovic J, et al. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis. Jt Bone Spine. 2018;85:317–22.CrossRef
19.
go back to reference Jenkins HH, Spencer ED, Weissgerber AJ, Osborne LA, Pellegrini JE. Correlating an 11-point verbal numeric rating scale to a 4-point verbal rating scale in the measurement of pruritus. J Perianesthesia Nurs. 2009;24:152–5.CrossRef Jenkins HH, Spencer ED, Weissgerber AJ, Osborne LA, Pellegrini JE. Correlating an 11-point verbal numeric rating scale to a 4-point verbal rating scale in the measurement of pruritus. J Perianesthesia Nurs. 2009;24:152–5.CrossRef
20.
go back to reference Kuettel D, Primdahl J, Christensen R, Ornbjerg LM, Horslev-Petersen K. Impact of patient-reported flares on radiographic progression and functional impairment in patients with rheumatoid arthritis: a cohort study based on the AMBRA trial. Scand J Rheumatol. 2018;47:87–94.CrossRefPubMed Kuettel D, Primdahl J, Christensen R, Ornbjerg LM, Horslev-Petersen K. Impact of patient-reported flares on radiographic progression and functional impairment in patients with rheumatoid arthritis: a cohort study based on the AMBRA trial. Scand J Rheumatol. 2018;47:87–94.CrossRefPubMed
21.
go back to reference Ometto F, Raffeiner B, Bernardi L, et al. Self-reported flares are predictors of radiographic progression in rheumatoid arthritis patients in 28-joint disease activity score remission: a 24-month observational study. Arthritis Res Ther. 2016;18:89.CrossRefPubMedPubMedCentral Ometto F, Raffeiner B, Bernardi L, et al. Self-reported flares are predictors of radiographic progression in rheumatoid arthritis patients in 28-joint disease activity score remission: a 24-month observational study. Arthritis Res Ther. 2016;18:89.CrossRefPubMedPubMedCentral
22.
go back to reference Gossec L, Paternotte S, Aanerud GJ, et al. Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann Rheum Dis. 2011;70:935–42.CrossRefPubMed Gossec L, Paternotte S, Aanerud GJ, et al. Finalisation and validation of the rheumatoid arthritis impact of disease score, a patient-derived composite measure of impact of rheumatoid arthritis: a EULAR initiative. Ann Rheum Dis. 2011;70:935–42.CrossRefPubMed
23.
go back to reference Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatol Int. 2017;37:1551–7.CrossRefPubMed Hunter TM, Boytsov NN, Zhang X, Schroeder K, Michaud K, Araujo AB. Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004–2014. Rheumatol Int. 2017;37:1551–7.CrossRefPubMed
24.
go back to reference Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016;75:3–15.CrossRefPubMed Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016;75:3–15.CrossRefPubMed
25.
go back to reference Barton JL. Patient preferences and satisfaction in the treatment of rheumatoid arthritis with biologic therapy. Patient Prefer Adherence. 2009;3:335–44.CrossRefPubMedPubMedCentral Barton JL. Patient preferences and satisfaction in the treatment of rheumatoid arthritis with biologic therapy. Patient Prefer Adherence. 2009;3:335–44.CrossRefPubMedPubMedCentral
26.
go back to reference Harrold LR, Reed GW, John A, et al. Cluster-randomized trial of a behavioral intervention to incorporate a treat-to-target approach to care of US patients with rheumatoid arthritis. Arthritis Care Res. 2018;70:379–87.CrossRef Harrold LR, Reed GW, John A, et al. Cluster-randomized trial of a behavioral intervention to incorporate a treat-to-target approach to care of US patients with rheumatoid arthritis. Arthritis Care Res. 2018;70:379–87.CrossRef
27.
go back to reference Kaufmann J, Feist E, Roske AE, Schmidt WA. Monotherapy with tocilizumab or TNF-alpha inhibitors in patients with rheumatoid arthritis: efficacy, treatment satisfaction, and persistence in routine clinical practice. Clin Rheumatol. 2013;32:1347–55.CrossRefPubMed Kaufmann J, Feist E, Roske AE, Schmidt WA. Monotherapy with tocilizumab or TNF-alpha inhibitors in patients with rheumatoid arthritis: efficacy, treatment satisfaction, and persistence in routine clinical practice. Clin Rheumatol. 2013;32:1347–55.CrossRefPubMed
28.
go back to reference van den Reek JM, van Luumig PP, Otero ME, et al. Satisfaction of treatment with biologics is high in psoriasis: results from the Bio-CAPTURE network. Br J Dermatol. 2014;170:1158–65.CrossRefPubMed van den Reek JM, van Luumig PP, Otero ME, et al. Satisfaction of treatment with biologics is high in psoriasis: results from the Bio-CAPTURE network. Br J Dermatol. 2014;170:1158–65.CrossRefPubMed
29.
go back to reference Goel N, Cummins G, Downing J, van Tuyl L. FRI0362 rapid acquisition of data on the patient perspective in rheumatoid arthritis through a digital portal. Ann Rheum Dis. 2015;74:557.CrossRef Goel N, Cummins G, Downing J, van Tuyl L. FRI0362 rapid acquisition of data on the patient perspective in rheumatoid arthritis through a digital portal. Ann Rheum Dis. 2015;74:557.CrossRef
31.
go back to reference Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23:13–45.CrossRef Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23:13–45.CrossRef
32.
go back to reference Califf RM. Benefit-risk assessments at the US food and drug administration: finding the balance. JAMA. 2017;317:693–4.CrossRefPubMed Califf RM. Benefit-risk assessments at the US food and drug administration: finding the balance. JAMA. 2017;317:693–4.CrossRefPubMed
Metadata
Title
Patient Perceptions of Unmet Medical Need in Rheumatoid Arthritis: A Cross-Sectional Survey in the USA
Authors
Christine Radawski
Mark C. Genovese
Brett Hauber
W. Benjamin Nowell
Kelly Hollis
Carol L. Gaich
Amy M. DeLozier
Kelly Gavigan
Maria Reynolds
Anabela Cardoso
Jeffrey R. Curtis
Publication date
01-09-2019
Publisher
Springer Healthcare
Published in
Rheumatology and Therapy / Issue 3/2019
Print ISSN: 2198-6576
Electronic ISSN: 2198-6584
DOI
https://doi.org/10.1007/s40744-019-00168-5

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