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Treatment Mode Preferences in Rheumatoid Arthritis: Moving Toward Shared Decision-Making

Authors Taylor PC, Betteridge N, Brown TM, Woolcott J, Kivitz AJ, Zerbini C, Whalley D, Olayinka-Amao O, Chen C, Dahl P, Ponce de Leon D, Gruben D, Fallon L

Received 10 July 2019

Accepted for publication 3 December 2019

Published 20 January 2020 Volume 2020:14 Pages 119—131


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Johnny Chen

Peter C Taylor, 1 Neil Betteridge, 2 T Michelle Brown, 3 John Woolcott, 4 Alan J Kivitz, 5 Cristiano Zerbini, 6 Diane Whalley, 7 Oyebimpe Olayinka-Amao, 3 Connie Chen, 8 Palle Dahl, 9 Dario Ponce de Leon, 10 David Gruben, 11 Lara Fallon 12

1Botnar Research Centre, University of Oxford, Oxford, UK; 2Neil Betteridge Associates, London, UK; 3Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Research Triangle Park, NC, USA; 4Patient and Health Impact, Health Economics and Outcomes Research, Pfizer Inc, Collegeville, PA, USA; 5Altoona Center for Clinical Research, Duncansville, PA, USA; 6Department of Rheumatology, Centro Paulista De Investigação Clinica, São Paulo, Brazil; 7Patient-Centered Outcomes Assessment Group, RTI Health Solutions, Manchester, UK; 8Xeljanz, Rheumatology, Inflammation & Immunology Medical Affairs, Pfizer Inc, New York, NY, USA; 9Medical Affairs, International Developed Markets, Inflammation & Immunology, Pfizer Inc, Ballerup, Denmark; 10Medical Affairs Latin-America, Pfizer Inc, New York, NY, USA; 11Statistical Research and Data Science Center, Pfizer Inc, Groton, CT, USA; 12Global Medical Affairs, Pfizer Inc, Montreal, QC, Canada

Correspondence: Peter C Taylor
Botnar Research Centre, University of Oxford, Windmill Road, Headington, Oxford OX3 7LD, UK
Tel +441865 227323

Purpose: Current knowledge of the reasons for patients’ preference for rheumatoid arthritis (RA) treatment modes is limited. This study was designed to identify preferences for four treatment modes, and to obtain in-depth information on the reasons for these preferences.
Patients and Methods: In this multi-national, cross-sectional, qualitative study, in-depth interviews were conducted with adult patients with RA in the United States, France, Germany, Italy, Spain, Switzerland, the United Kingdom, and Brazil. Patients’ strength of preference was evaluated using a 100-point allocation task (0– 100; 100=strongest) across four treatment modes: oral, self-injection, clinic-injection, and infusion. Qualitative descriptive analysis methods were used to identify, characterize, and summarize patterns found in the interview data relating to reasons for these preferences.
Results: 100 patients were interviewed (female, 75.0%; mean age, 53.9 years; mean 11.6 years since diagnosis). Among the four treatment modes, oral administration was allocated the highest mean (standard deviation) preference points (47.3 [33.1]) and was ranked first choice by the greatest percentage of patients (57.0%), followed by self-injection (29.7 [27.7]; 29.0%), infusion (15.4 [24.6]; 16.0%), and clinic-injection (7.5 [14.1]; 2.0%). Overall, 56.0% of patients had a “strong” first-choice preference (ie, point allocation ≥ 70); most of these patients chose oral (62.5%) vs self-injection (23.2%), infusion (10.7%), or clinic-injection (3.6%). Speed and/or ease of administration were the most commonly reported reasons for patients choosing oral (52.6%) or self-injection (55.2%). The most common reasons for patients not choosing oral or self-injection were not wanting to take another pill (37.2%) and avoiding pain due to needles (46.5%), respectively.
Conclusion: These data report factors important to patients regarding preferences for RA treatment modes. Patients may benefit from discussions with their healthcare professionals and/or patient support groups, regarding RA treatment modes, to facilitate shared decision-making.

Keywords: drug administration, patient perspective, qualitative research, surveys

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