The patient perspective on biologic DMARD dose reduction in rheumatoid arthritis: a mixed methods study

Rheumatology
Lise M VerhoefMarlies E Hulscher

Abstract

The aim of this study was to identify the factors that play a role for patients with RA when considering dose reduction (i.e. gradual tapering until discontinuation) of biological DMARDs (bDMARDs), and to determine their relative importance. A mixed methods design was used in which we identified influencing factors by performing semi-structured interviews and ranked these factors using a Maximum Difference Scaling questionnaire. Also, we looked at the influence of several patient characteristics on this ranking. For sub study 1 and 2, 22 and 192 patients with RA were included, respectively, in the analyses. Thirty factors were identified from the interviews-characterized into nine themes-and appraised in the questionnaire. Most respondents had a positive attitude towards bDMARD dose reduction. The study showed that patients are concerned that dose reduction will lead to a disease flare that affects their daily life (pain, function). It is important for them to know that it is possible to increase the dose if (further) reduction fails and that the bDMARD will be effective again. Patients value the opinion of their rheumatologist, and being involved in the decision to start tapering is highly ranked as well. The most important fa...Continue Reading

References

Nov 27, 2002·Quality & Safety in Health Care·C PopeR Baker
Mar 17, 2004·Annals of the Rheumatic Diseases·L FraenkelD R Wittink
Aug 6, 2013·Drugs & Aging·Emily ReeveMichael D Wiese
Oct 5, 2014·BMC Musculoskeletal Disorders·Ingrid NotaMart A F J van de Laar
Nov 8, 2015·Arthritis Care & Research·Jasvinder A SinghTimothy McAlindon
Jan 9, 2016·Health Economics Review·Axel C MühlbacherF Reed Johnson
Jul 13, 2016·PharmacoEconomics·Kei Long CheungMickael Hiligsmann
Mar 4, 2017·Rheumatology and Therapy·Lise M VerhoefAlfons A den Broeder

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Citations

Feb 13, 2019·Current Opinion in Rheumatology·Betty Hsiao, Liana Fraenkel
Jan 17, 2021·Drugs·C A J MichielsensE M G J de Jong
Jul 19, 2020·Joint, Bone, Spine : Revue Du Rhumatisme·Jasvinder A SinghSusan M Goodman

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