Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study

Objective To describe patients’ perspectives on the burden associated with methotrexate (MTX) or tumor necrosis factor inhibitor (TNFi) use in psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Methods Between May 2019 and March 2020, patients receiving MTX and/or a TNFi for either PsA or RA w...

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Main Authors: Alexis Ogdie, Yomei Shaw, Michele Almonte, Ervant J. Maksabedian Hernandez, Bradley Stolshek, Kaleb Michaud
Format: Article
Language:English
Published: Wiley 2023-04-01
Series:ACR Open Rheumatology
Online Access:https://doi.org/10.1002/acr2.11530
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author Alexis Ogdie
Yomei Shaw
Michele Almonte
Ervant J. Maksabedian Hernandez
Bradley Stolshek
Kaleb Michaud
author_facet Alexis Ogdie
Yomei Shaw
Michele Almonte
Ervant J. Maksabedian Hernandez
Bradley Stolshek
Kaleb Michaud
author_sort Alexis Ogdie
collection DOAJ
description Objective To describe patients’ perspectives on the burden associated with methotrexate (MTX) or tumor necrosis factor inhibitor (TNFi) use in psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Methods Between May 2019 and March 2020, patients receiving MTX and/or a TNFi for either PsA or RA were randomly sampled from the FORWARD data bank and were invited to participate in semistructured telephone interviews. Interviews explored patients’ perspectives on treatment burden and experiences with MTX and TNFi and were conducted until data saturation was achieved. Interviews were recorded, transcribed, and analyzed using a grounded theory approach and NVivo v12.0 software. Results Overall, 25 patients with PsA and 24 patients with RA participated in the interviews. Participants were predominantly women (mean age: 67 years). Nine major themes related to treatment burden were explored, including treatment side effects and their management, psychological burden, effect on daily functioning and work participation, challenges with accessing and administering therapies, financial difficulties or economic impact, and family planning or breastfeeding. Patients receiving MTX mostly reported side effects as the major burden, while cost and concerns with accessing and administering medication were major challenges reported by TNFi users. Treatment discontinuation due to lack of effectiveness was high for PsA, while discontinuation due to medication cost was high for RA. Conclusion Patients experience a wide range of burden associated with treatments used for PsA and RA. Health care practitioners should consider these challenges when prescribing therapy and strive toward reducing this burden by understanding patients’ concerns and needs and involving them in decision making.
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spelling doaj.art-eb5baf57a6fe4138a9b3bf433fa5c73e2023-04-13T14:12:31ZengWileyACR Open Rheumatology2578-57452023-04-015416717210.1002/acr2.11530Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative StudyAlexis Ogdie0Yomei Shaw1Michele Almonte2Ervant J. Maksabedian Hernandez3Bradley Stolshek4Kaleb Michaud5Perelman School of Medicine at the University of Pennsylvania PhiladelphiaFORWARD, The National Databank for Rheumatic Diseases Kansas WichitaPenn Presbyterian Medical Center Pennsylvania PhiladelphiaBristol Myers Squibb New Jersey Princeton PikeAmgen Inc California Thousand OaksAmgen Inc California Thousand OaksObjective To describe patients’ perspectives on the burden associated with methotrexate (MTX) or tumor necrosis factor inhibitor (TNFi) use in psoriatic arthritis (PsA) and rheumatoid arthritis (RA). Methods Between May 2019 and March 2020, patients receiving MTX and/or a TNFi for either PsA or RA were randomly sampled from the FORWARD data bank and were invited to participate in semistructured telephone interviews. Interviews explored patients’ perspectives on treatment burden and experiences with MTX and TNFi and were conducted until data saturation was achieved. Interviews were recorded, transcribed, and analyzed using a grounded theory approach and NVivo v12.0 software. Results Overall, 25 patients with PsA and 24 patients with RA participated in the interviews. Participants were predominantly women (mean age: 67 years). Nine major themes related to treatment burden were explored, including treatment side effects and their management, psychological burden, effect on daily functioning and work participation, challenges with accessing and administering therapies, financial difficulties or economic impact, and family planning or breastfeeding. Patients receiving MTX mostly reported side effects as the major burden, while cost and concerns with accessing and administering medication were major challenges reported by TNFi users. Treatment discontinuation due to lack of effectiveness was high for PsA, while discontinuation due to medication cost was high for RA. Conclusion Patients experience a wide range of burden associated with treatments used for PsA and RA. Health care practitioners should consider these challenges when prescribing therapy and strive toward reducing this burden by understanding patients’ concerns and needs and involving them in decision making.https://doi.org/10.1002/acr2.11530
spellingShingle Alexis Ogdie
Yomei Shaw
Michele Almonte
Ervant J. Maksabedian Hernandez
Bradley Stolshek
Kaleb Michaud
Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
ACR Open Rheumatology
title Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
title_full Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
title_fullStr Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
title_full_unstemmed Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
title_short Perspectives on Treatment Burden for Methotrexate and Tumor Necrosis Factor Inhibitors Among Patients With Psoriatic Arthritis and Rheumatoid Arthritis: A Qualitative Study
title_sort perspectives on treatment burden for methotrexate and tumor necrosis factor inhibitors among patients with psoriatic arthritis and rheumatoid arthritis a qualitative study
url https://doi.org/10.1002/acr2.11530
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