Patients with rheumatoid arthritis (RA) consider functional capacity and potential side effects as important treatment attributes for making decisions regarding individualized RA management, according to findings from a survey study published in Clinical Rheumatology.

The survey included 184 patients with RA from Sweden who were asked in an online survey to rank important treatment attributes that should be considered when individualizing RA management. Investigators conducted semi-structured interviews to identify and frame the potential treatment attributes for shared decision making. Rheumatologists and patient research partners were asked to support the selection and framing of the treatment attributes across evaluation.

Among all respondents included in the assessment, the highest ranked attributes included improved functional capacity, reduced inflammation, reduced pain and fatigue, as well as the risk for severe side effects from therapy.


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In the framework analysis, the researchers identified 2 overarching themes for exploration, including treatment goals and treatment side effects. The first theme concerning “treatment goals” emerged from functional capacity and revealed 2 dimensions: physical functional capacity and psychosocial functional capacity. In contrast, the “side effects” revealed that mild and severe adverse effects from therapy were considered the most important attributes to discuss during a shared decision-making process.

A potential limitation of the survey study was the recruitment of participants via a mobile phone application, which may have excluded relevant patients who do not use or do not know how to use mobile applications.

The researchers concluded that recommendations for personalized management of RA should include attributes most important from the patient perspective, as this can assist in shared decision making. “Quantitative assessments of patient-relevant benefits and risks may support patients in shared decision-making, so treatment decisions can be aligned with their preferences,” the researchers wrote.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Bywall KS, Esbensen BA, Lason M, Heidenvall M, Erlandsson I, Johansson JV. Functional capacity vs side effects: treatment attributes to consider when individualising treatment for patients with rheumatoid arthritisClin Rheumatol. Published online October 15, 2021. doi:10.1007/s10067-021-05961-8