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Functional capacity vs side effects: treatment attributes to consider when individualising treatment for patients with rheumatoid arthritis

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  • Karin Schölin Bywall
  • Bente Appel Esbensen
  • Marta Lason
  • Marie Heidenvall
  • Inger Erlandsson
  • Jennifer Viberg Johansson
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INTRODUCTION: Individualisation of rheumatoid arthritis (RA) treatment needs to take account of individual patients' preferences to increase patient-centeredness in treatment decisions. The aim of this study was to identify patient-relevant treatment attributes to consider when individualising treatment for patients with RA.

METHOD: Patients with RA in Sweden were invited to rank the most important treatment attributes in an online survey (April to May 2020). Semi-structured interviews were conducted (October to November 2020) to further identify and frame potential attributes for shared decision-making. The interviews were audio-recorded, transcribed and analysed using thematic framework analysis. Patient research partners and rheumatologists supported the selection and framing of the treatment attributes across the assessment.

RESULTS: The highest ranked attributes (N = 184) were improved functional capacity, reduced inflammation, reduced pain and fatigue and the risk of getting a severe side effect. The framework analysis revealed two overarching themes for further exploration: treatment goals and side effects. 'Treatment goals' emerged from functional capacity, revealing two dimensions: physical functional capacity and psychosocial functional capacity. 'Side effects' revealed that mild and severe side effects were the most important to discuss in shared decision-making.

CONCLUSIONS: Functional capacity (physical and psychosocial) and potential side effects (mild and severe) are important treatment attributes to consider when individualising RA treatment. Future research should assess how patients with RA weigh benefits and risks against each other, in order to increase patient-centeredness early on the treatment trajectory.

Original languageEnglish
JournalClinical Rheumatology
Volume41
Issue number3
Pages (from-to)695-704
ISSN0770-3198
DOIs
Publication statusPublished - Mar 2022

Bibliographical note

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    Research areas

  • Discrete choice experiment, Individualisation of treatment, Patient preferences, Rheumatoid arthritis, Shared decision-making

ID: 68506636