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Patient preferences for rheumatoid arthritis treatments: results from the national cross-sectional LERACS study

Authors Fayad F, Ziade NR, Merheb G, Attoui S, Aiko A, Mroue K, Masri AF

Received 3 May 2018

Accepted for publication 17 July 2018

Published 31 August 2018 Volume 2018:12 Pages 1619—1625

DOI https://doi.org/10.2147/PPA.S168738

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen


Fouad Fayad,1 Nelly R Ziade,1 Georges Merheb,2 Said Attoui,3 Alla Aiko,4 Kamel Mroue,3 Abdel Fattah Masri5

1Rheumatology Department, Hotel Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon; 2Department of Rheumatology, Notre Dame des Secours University Hospital, Jbeil, Lebanon, Holy Spirit University, Kaslik, Lebanon; 3Rheumatology Department, Hammoud University Medical Center, Saida, Lebanon; 4Department of Medicine (Rheumatology), Saint George Hospital, Beirut, Lebanon; 5Department of Internal Medicine (Rheumatology), American University of Beirut Medical Center, Beirut, Lebanon

Introduction: To investigate the treatment preferences of patients with rheumatoid arthritis (RA) and determine whether these preferences are related to specific disease characteristics.
Method: A national survey was designed to collect demographic, disease, treatment, and preference data on RA patients enrolled in 7 private and university hospital clinics in Lebanon. Associations between patient factors and treatment preferences for RA were analyzed by χ2 or Mann–Whitney U test.
Results: A total of 693 patients (83% female; 67% aged 41–70 years) consulting 7 trained rheumatologists completed the survey. Most patients (80%) had established RA >24 months, and approximately one-third (34%) were in remission according to the disease activity score in 28 joints (DAS28). Most (87%) were receiving oral agents (60% oral only). Almost two-thirds of patients (64%) expressed a preference for oral treatments, and more than half (53%) ranked doctor’s advice as the most influential factor when choosing treatment. In univariable analysis, health coverage, radiographic damage, disease duration, current therapy, and previous side effects were significantly associated with treatment preference. In multivariable analyses, only radiographic damage and current route of administration were independently associated with preference (both P<0.001), with patients with no radiographic damage and those on oral-only therapy being more likely to prefer oral agents.
Conclusion: RA patients expressed a preference for oral rather than subcutaneous/intravenous-administered drugs. Understanding patients’ preferences may help to inform policymaker decisions.

Keywords: rheumatoid arthritis, administration, patient, preference

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