Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment
Abstract Aim Early assessment of patient preferences has the potential to support shared decisions in personalized precision medicine for patients with rheumatoid arthritis (RA). The aim of this study was to assess treatment preferences of patients with RA (< 5 years) with previous experience of...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-07-01
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| Series: | BMC Rheumatology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41927-023-00341-y |
| _version_ | 1797784335873474560 |
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| author | Karin Schölin Bywall Bente Appel Esbensen Marie Heidenvall Inger Erlandsson Marta Lason Mats Hansson Jennifer Viberg Johansson |
| author_facet | Karin Schölin Bywall Bente Appel Esbensen Marie Heidenvall Inger Erlandsson Marta Lason Mats Hansson Jennifer Viberg Johansson |
| author_sort | Karin Schölin Bywall |
| collection | DOAJ |
| description | Abstract Aim Early assessment of patient preferences has the potential to support shared decisions in personalized precision medicine for patients with rheumatoid arthritis (RA). The aim of this study was to assess treatment preferences of patients with RA (< 5 years) with previous experience of inadequate response to first-line monotherapy. Method Patients were recruited (March–June 2021) via four clinics in Sweden. Potential respondents (N = 933) received an invitation to answer a digital survey. The survey included an introductory part, a discrete choice experiment (DCE) and demographic questions. Each respondent answered 11 hypothetical choice questions as part of the DCE. Patient preferences and preference heterogeneity were estimated using random parameter logit models and latent class analysis models. Results Patients (n = 182) assessed the most important treatment attributes out of physical functional capacity, psychosocial functional capacity, frequency of mild side effects and likelihood of severe side effects. In general, patients preferred a greater increase in functional capacity and decreased side effects. However, a substantial preference heterogeneity was identified with two underlying preference patterns. The most important attribute in the first pattern was the ‘likelihood of getting a severe side effect’. Physical functional capacity was the most important attribute in the second pattern. Conclusion Respondents focused their decision-making mainly on increasing their physical functional capacity or decreasing the likelihood of getting a severe side effect. These results are highly relevant from a clinical perspective to strengthen communication in shared decision making by assessing patients’ individual preferences for benefits and risks in treatment discussions. |
| first_indexed | 2024-03-13T00:38:26Z |
| format | Article |
| id | doaj.art-19f1ff2e48574e5798200fe713360d9e |
| institution | Directory Open Access Journal |
| issn | 2520-1026 |
| language | English |
| last_indexed | 2024-03-13T00:38:26Z |
| publishDate | 2023-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Rheumatology |
| spelling | doaj.art-19f1ff2e48574e5798200fe713360d9e2023-07-09T11:27:47ZengBMCBMC Rheumatology2520-10262023-07-017111010.1186/s41927-023-00341-yPhysical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatmentKarin Schölin Bywall0Bente Appel Esbensen1Marie Heidenvall2Inger Erlandsson3Marta Lason4Mats Hansson5Jennifer Viberg Johansson6School of Health, Care and Social Welfare, Division of Health and Welfare Technology, Mälardalen UniversityCopenhagen Center for Arthritis Research (COPECARE), Center for Rheumatology and Spine Diseases, Centre of Head and Orthopaedics, RigshospitaletRheumatism AssociationRheumatism AssociationElsa ScienceDepartment of Public Health and Caring Sciences, Centre for Research Ethics & Bioethics, Uppsala UniversityDepartment of Public Health and Caring Sciences, Centre for Research Ethics & Bioethics, Uppsala UniversityAbstract Aim Early assessment of patient preferences has the potential to support shared decisions in personalized precision medicine for patients with rheumatoid arthritis (RA). The aim of this study was to assess treatment preferences of patients with RA (< 5 years) with previous experience of inadequate response to first-line monotherapy. Method Patients were recruited (March–June 2021) via four clinics in Sweden. Potential respondents (N = 933) received an invitation to answer a digital survey. The survey included an introductory part, a discrete choice experiment (DCE) and demographic questions. Each respondent answered 11 hypothetical choice questions as part of the DCE. Patient preferences and preference heterogeneity were estimated using random parameter logit models and latent class analysis models. Results Patients (n = 182) assessed the most important treatment attributes out of physical functional capacity, psychosocial functional capacity, frequency of mild side effects and likelihood of severe side effects. In general, patients preferred a greater increase in functional capacity and decreased side effects. However, a substantial preference heterogeneity was identified with two underlying preference patterns. The most important attribute in the first pattern was the ‘likelihood of getting a severe side effect’. Physical functional capacity was the most important attribute in the second pattern. Conclusion Respondents focused their decision-making mainly on increasing their physical functional capacity or decreasing the likelihood of getting a severe side effect. These results are highly relevant from a clinical perspective to strengthen communication in shared decision making by assessing patients’ individual preferences for benefits and risks in treatment discussions.https://doi.org/10.1186/s41927-023-00341-yPrecision medicineRheumatoid arthritisIndividualised treatmentShared decision-making |
| spellingShingle | Karin Schölin Bywall Bente Appel Esbensen Marie Heidenvall Inger Erlandsson Marta Lason Mats Hansson Jennifer Viberg Johansson Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment BMC Rheumatology Precision medicine Rheumatoid arthritis Individualised treatment Shared decision-making |
| title | Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment |
| title_full | Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment |
| title_fullStr | Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment |
| title_full_unstemmed | Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment |
| title_short | Physical function and severe side effects matter most to patients with RA (< 5 years): a discrete choice experiment assessing preferences for personalized RA treatment |
| title_sort | physical function and severe side effects matter most to patients with ra 5 years a discrete choice experiment assessing preferences for personalized ra treatment |
| topic | Precision medicine Rheumatoid arthritis Individualised treatment Shared decision-making |
| url | https://doi.org/10.1186/s41927-023-00341-y |
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