Skip to main content
Top
Published in: Rheumatology and Therapy 4/2023

Open Access 19-05-2023 | Rheumatoid Arthritis | Original Research

Patient–Physician Communication and Perception of Treatment Goals in Rheumatoid Arthritis: An Online Survey of Patients and Physicians

Authors: Shigeki Momohara, Kei Ikeda, Masahiro Tada, Toshiaki Miyamoto, Takanori Mito, Keita Fujimoto, Ayako Shoji, Eriko Wakita, Mitsumasa Kishimoto

Published in: Rheumatology and Therapy | Issue 4/2023

Login to get access

Abstract

Introduction

To evaluate patient–physician communication and patients’ understanding of treatment goals in rheumatoid arthritis (RA).

Methods

A cross-sectional online survey of patients with RA and physicians treating RA was conducted between 16 and 30 June 2021. Participants were asked to rate the importance of 17 goals on a 6-point Likert scale, and mean scores were compared between patients and physicians by the Wilcoxon rank sum test. Patients’ satisfaction with physician communication and their understanding of treatment goals were also assessed.

Results

The responses of 502 patients and 216 physicians were analyzed. The most common patient age group was 50–59 years (28.5%), and the mean disease duration was 10.3 years. Physicians had a mean of 19.2 years of treatment experience and were treating a mean of 44.3 patients. Among the 17 goals assessed, patients placed significantly more importance on drug tapering or discontinuation as short-term goals (3–6 months) and on performing basic activities of daily living, being able to engage in daily tasks, achieving and maintaining remission, maintaining better laboratory values, and drug tapering or discontinuation as long-term goals (5–10 years; all adjusted p < 0.05). Patient treatment satisfaction was significantly associated with disease activity, a feeling of treatment effectiveness, satisfaction with physician communication, and agreement with physician goals.

Conclusion

Differences exist among patients with RA and physicians treating RA regarding the importance of short- and long-term treatment goals. Good patient–physician communication appears to be important for improving patient satisfaction.

Trial registration

University Hospital Medical Information Network identifier: UMIN000044463.
Appendix
Available only for authorised users
Literature
1.
go back to reference Yamanaka H, Tanaka E, Nakajima A, et al. A large observational cohort study of rheumatoid arthritis, IORRA: providing context for today’s treatment options. Mod Rheumatol. 2020;30(1):1–6.CrossRefPubMed Yamanaka H, Tanaka E, Nakajima A, et al. A large observational cohort study of rheumatoid arthritis, IORRA: providing context for today’s treatment options. Mod Rheumatol. 2020;30(1):1–6.CrossRefPubMed
2.
go back to reference Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685–99.CrossRefPubMed Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685–99.CrossRefPubMed
3.
go back to reference Japan College of Rheumatology. Guidelines for the management of rheumatoid arthritis: diagnosis and treatment. Tokyo: Japan College of Rheumatology; 2020 (in Japanese). Japan College of Rheumatology. Guidelines for the management of rheumatoid arthritis: diagnosis and treatment. Tokyo: Japan College of Rheumatology; 2020 (in Japanese).
4.
go back to reference Kojima M, Hasegawa M, Hirata S, et al. Patients’ perspectives of rheumatoid arthritis treatment: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines. Mod Rheumatol. 2022;32:307–12.CrossRefPubMed Kojima M, Hasegawa M, Hirata S, et al. Patients’ perspectives of rheumatoid arthritis treatment: a questionnaire survey for the 2020 update of the Japan college of rheumatology clinical practice guidelines. Mod Rheumatol. 2022;32:307–12.CrossRefPubMed
6.
go back to reference Nagy G, Roodenrijs NMT, Welsing PM, et al. EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 2021;80(1):31–5.CrossRefPubMed Nagy G, Roodenrijs NMT, Welsing PM, et al. EULAR definition of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 2021;80(1):31–5.CrossRefPubMed
7.
go back to reference Takanashi S, Kaneko Y, Takeuchi T. Characteristics of patients with difficult-to-treat rheumatoid arthritis in clinical practice. Rheumatology (Oxford). 2021;60(11):5247–56.CrossRefPubMed Takanashi S, Kaneko Y, Takeuchi T. Characteristics of patients with difficult-to-treat rheumatoid arthritis in clinical practice. Rheumatology (Oxford). 2021;60(11):5247–56.CrossRefPubMed
8.
go back to reference Roodenrijs NMT, van der Goes MC, Welsing PMJ, et al. Difficult-to-treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology (Oxford). 2021;60(8):3778–88.CrossRefPubMed Roodenrijs NMT, van der Goes MC, Welsing PMJ, et al. Difficult-to-treat rheumatoid arthritis: contributing factors and burden of disease. Rheumatology (Oxford). 2021;60(8):3778–88.CrossRefPubMed
9.
go back to reference Kaneko Y, Sato M, Cai Z, Sato M. Assessment of discordance of treatment satisfaction between patients with rheumatoid arthritis in low disease activity or in remission and their treating physicians: a cross-sectional survey. Mod Rheumatol. 2021;31(2):326–33.CrossRefPubMed Kaneko Y, Sato M, Cai Z, Sato M. Assessment of discordance of treatment satisfaction between patients with rheumatoid arthritis in low disease activity or in remission and their treating physicians: a cross-sectional survey. Mod Rheumatol. 2021;31(2):326–33.CrossRefPubMed
10.
go back to reference Studenic P, Radner H, Smolen JS, Aletaha D. Discrepancies between patients and physicians in their perceptions of rheumatoid arthritis disease activity. Arthritis Rheum. 2012;64(9):2814–23.CrossRefPubMed Studenic P, Radner H, Smolen JS, Aletaha D. Discrepancies between patients and physicians in their perceptions of rheumatoid arthritis disease activity. Arthritis Rheum. 2012;64(9):2814–23.CrossRefPubMed
11.
go back to reference Kaneko Y, Kondo H, Takeuchi T. American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis maintain reliable performance when evaluated in 44 joints. J Rheumatol. 2013;40(8):1254–8.CrossRefPubMed Kaneko Y, Kondo H, Takeuchi T. American College of Rheumatology/European League Against Rheumatism remission criteria for rheumatoid arthritis maintain reliable performance when evaluated in 44 joints. J Rheumatol. 2013;40(8):1254–8.CrossRefPubMed
12.
go back to reference Alves Pereira I, Maldonado Cocco J, Feijó Azevedo V, et al. Levels of satisfaction with rheumatoid arthritis treatment and associated alignment between physicians and patients across Latin America. Clin Rheumatol. 2020;39(6):1813–22.CrossRefPubMed Alves Pereira I, Maldonado Cocco J, Feijó Azevedo V, et al. Levels of satisfaction with rheumatoid arthritis treatment and associated alignment between physicians and patients across Latin America. Clin Rheumatol. 2020;39(6):1813–22.CrossRefPubMed
13.
go back to reference Jiang N, Yang P, Liu S, et al. Satisfaction of patients and physicians with treatments for rheumatoid arthritis: a population-based survey in China. Patient Prefer Adher. 2020;14:1037–47.CrossRef Jiang N, Yang P, Liu S, et al. Satisfaction of patients and physicians with treatments for rheumatoid arthritis: a population-based survey in China. Patient Prefer Adher. 2020;14:1037–47.CrossRef
17.
go back to reference Pincus T, Yazici Y, Bergman MJ. RAPID3, an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts: similar results to DAS28 and CDAI in clinical trials and clinical care. Rheum Dis Clin North Am. 2009;35(4):773–8.CrossRefPubMed Pincus T, Yazici Y, Bergman MJ. RAPID3, an index to assess and monitor patients with rheumatoid arthritis, without formal joint counts: similar results to DAS28 and CDAI in clinical trials and clinical care. Rheum Dis Clin North Am. 2009;35(4):773–8.CrossRefPubMed
18.
go back to reference Pincus T, Swearingen C, Wolfe F. Toward a multidimensional health assessment questionnaire (MDHAQ): assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis Rheum. 1999;42(10):2220–30.CrossRefPubMed Pincus T, Swearingen C, Wolfe F. Toward a multidimensional health assessment questionnaire (MDHAQ): assessment of advanced activities of daily living and psychological status in the patient-friendly health assessment questionnaire format. Arthritis Rheum. 1999;42(10):2220–30.CrossRefPubMed
19.
go back to reference Pincus T, Hassett AL, Callahan LF. Criterion contamination of depression scales in patients with rheumatoid arthritis: the need for interpretation of patient questionnaires (as all clinical measures) in the context of all information about the patient. Rheum Dis Clin North Am. 2009;35(4):861–4.CrossRefPubMed Pincus T, Hassett AL, Callahan LF. Criterion contamination of depression scales in patients with rheumatoid arthritis: the need for interpretation of patient questionnaires (as all clinical measures) in the context of all information about the patient. Rheum Dis Clin North Am. 2009;35(4):861–4.CrossRefPubMed
20.
go back to reference Nakajima A, Sakai R, Inoue E, Harigai M. Prevalence of patients with rheumatoid arthritis and age-stratified trends in clinical characteristics and treatment, based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Int J Rheum Dis. 2020;23(12):1676–84.CrossRefPubMed Nakajima A, Sakai R, Inoue E, Harigai M. Prevalence of patients with rheumatoid arthritis and age-stratified trends in clinical characteristics and treatment, based on the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Int J Rheum Dis. 2020;23(12):1676–84.CrossRefPubMed
21.
go back to reference Yamanaka H, Sugiyama N, Inoue E, Taniguchi A, Momohara S. Estimates of the prevalence of and current treatment practices for rheumatoid arthritis in Japan using reimbursement data from health insurance societies and the IORRA cohort (I). Mod Rheumatol. 2014;24(1):33–40.CrossRefPubMed Yamanaka H, Sugiyama N, Inoue E, Taniguchi A, Momohara S. Estimates of the prevalence of and current treatment practices for rheumatoid arthritis in Japan using reimbursement data from health insurance societies and the IORRA cohort (I). Mod Rheumatol. 2014;24(1):33–40.CrossRefPubMed
22.
go back to reference Kameda H, Fujii T, Nakajima A, et al. Japan College of Rheumatology guideline for the use of methotrexate in patients with rheumatoid arthritis. Mod Rheumatol. 2019;29(1):31–40.CrossRefPubMed Kameda H, Fujii T, Nakajima A, et al. Japan College of Rheumatology guideline for the use of methotrexate in patients with rheumatoid arthritis. Mod Rheumatol. 2019;29(1):31–40.CrossRefPubMed
23.
go back to reference Lillegraven S, Paulshus Sundlisæter N, Aga AB, et al. Effect of half-dose vs stable-dose conventional synthetic disease-modifying antirheumatic drugs on disease flares in patients with rheumatoid arthritis in remission: the ARCTIC REWIND randomized clinical trial. JAMA. 2021;325(17):1755–64.CrossRefPubMedPubMedCentral Lillegraven S, Paulshus Sundlisæter N, Aga AB, et al. Effect of half-dose vs stable-dose conventional synthetic disease-modifying antirheumatic drugs on disease flares in patients with rheumatoid arthritis in remission: the ARCTIC REWIND randomized clinical trial. JAMA. 2021;325(17):1755–64.CrossRefPubMedPubMedCentral
24.
go back to reference Benham H, Chiu H, Tesiram J, et al. A patient-centered knowledge translation tool for treat-to-target strategy in rheumatoid arthritis: patient and rheumatologist perspectives. Int J Rheum Dis. 2021;24(3):355–63.CrossRefPubMed Benham H, Chiu H, Tesiram J, et al. A patient-centered knowledge translation tool for treat-to-target strategy in rheumatoid arthritis: patient and rheumatologist perspectives. Int J Rheum Dis. 2021;24(3):355–63.CrossRefPubMed
25.
go back to reference Welsing PM, van Gestel AM, Swinkels HL, Kiemeney LA, van Riel PL. The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum. 2001;44(9):2009–17.CrossRefPubMed Welsing PM, van Gestel AM, Swinkels HL, Kiemeney LA, van Riel PL. The relationship between disease activity, joint destruction, and functional capacity over the course of rheumatoid arthritis. Arthritis Rheum. 2001;44(9):2009–17.CrossRefPubMed
26.
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(11):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(11):2046–54.CrossRefPubMed
27.
go back to reference McInnes IB, Combe B, Burmester G. Understanding the patient perspective—results of the rheumatoid arthritis: insights, strategies & expectations (RAISE) patient needs survey. Clin Exp Rheumatol. 2013;31:350–7.PubMed McInnes IB, Combe B, Burmester G. Understanding the patient perspective—results of the rheumatoid arthritis: insights, strategies & expectations (RAISE) patient needs survey. Clin Exp Rheumatol. 2013;31:350–7.PubMed
28.
go back to reference Lwin MN, Serhal L, Holroyd C, Edwards CJ. Rheumatoid arthritis: the impact of mental health on disease: a narrative review. Rheumatol Ther. 2020;7(3):457–71.CrossRefPubMedPubMedCentral Lwin MN, Serhal L, Holroyd C, Edwards CJ. Rheumatoid arthritis: the impact of mental health on disease: a narrative review. Rheumatol Ther. 2020;7(3):457–71.CrossRefPubMedPubMedCentral
29.
go back to reference Taylor P, Manger B, Alvaro-Gracia J, et al. Patient perceptions concerning pain management in the treatment of rheumatoid arthritis. J Int Med Res. 2010;38:1213–24.CrossRefPubMed Taylor P, Manger B, Alvaro-Gracia J, et al. Patient perceptions concerning pain management in the treatment of rheumatoid arthritis. J Int Med Res. 2010;38:1213–24.CrossRefPubMed
30.
go back to reference Hughes M, Chalk A, Sharma P, Dahiya S, Galloway J. A cross-sectional study of sleep and depression in a rheumatoid arthritis population. Clin Rheumatol. 2021;40(4):1299–305.CrossRefPubMed Hughes M, Chalk A, Sharma P, Dahiya S, Galloway J. A cross-sectional study of sleep and depression in a rheumatoid arthritis population. Clin Rheumatol. 2021;40(4):1299–305.CrossRefPubMed
Metadata
Title
Patient–Physician Communication and Perception of Treatment Goals in Rheumatoid Arthritis: An Online Survey of Patients and Physicians
Authors
Shigeki Momohara
Kei Ikeda
Masahiro Tada
Toshiaki Miyamoto
Takanori Mito
Keita Fujimoto
Ayako Shoji
Eriko Wakita
Mitsumasa Kishimoto
Publication date
19-05-2023
Publisher
Springer Healthcare
Published in
Rheumatology and Therapy / Issue 4/2023
Print ISSN: 2198-6576
Electronic ISSN: 2198-6584
DOI
https://doi.org/10.1007/s40744-023-00560-2

Other articles of this Issue 4/2023

Rheumatology and Therapy 4/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine