Financial aspects of rheumatoid arthritis (RA) care and medication risk aversion are among the top patient- and rheumatologist-reported barriers to achieving RA disease control, according to results published in Arthritis Care & Research.

The study included patients with RA and rheumatologists from the Consortium of Rheumatology Researchers of North American (Corrona) registry. Participants were invited by email to take part in nominal groups (NGs). The researchers created 2 separate lists of barriers from patients with RA-only NGs and rheumatologist-only NGs. They sorted the barriers into themes.

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Using an online survey, the researchers then asked a random sample of patients with RA from the Corrona registry to rank their top 3 barriers to achieving disease control.

The researchers conducted 4 NGs with 37 patients with RA and classified patient barriers into 17 themes. Similarly, they conducted 3 NGs with 25 rheumatologists and classified those barriers into 11 themes.

In both patient- and rheumatologist-only NGs, financial aspects of RA care ranked first as the top barrier to achieving care. Medication risk aversion ranked second in the rheumatologist-only NGs, and it ranked third in the patient-only NGs.

Of the 450 patients with RA who were subsequently surveyed, 77% considered RA a top health priority, and 51% reported being aware of the treat-to-target (T2T) strategy for RA care.

The online survey respondents ranked RA prognosis uncertainty, medication risk aversion, and the financial/administrative burden associated with RA care as the 3 most important challenges to achieving disease control.

“An intervention addressing perceived obstacles to achieving disease control may facilitate meaningful conversations and shared decision making between patients and physicians, improve adherence to goal-directed RA care espoused by the T2T strategy, and thus result in improved quality of life of patients with RA,” the researchers wrote.

Reference
Owensby JK, Chen L, O’Beirne R, et al. Patient- and rheumatologist-perspectives regarding challenges to achieving optimal disease control in rheumatoid arthritis [published online April 22, 2019]. Arthritis Care Res (Hoboken). doi:10.1002/acr.23907