Comparison of the Effects of a Pharmaceutical Industry Decision Guide and Decision Aids on Patient Choice to Intensify Therapy in Rheumatoid Arthritis
نویسندگان
چکیده
OBJECTIVE To compare the effects a pharmaceutical industry decision guide and International Patient Decision Aids Standard (IPDAS) compliant patient decision aids (PtDA) on patient medication beliefs and choice to intensify therapy. METHODS Rheumatoid arthritis (RA) patients, who had never taken etanercept (Enbrel), took part in a mail survey. They were presented with a hypothetical decision scenario where they were asked to consider adding etanercept to their current regimen. Each patient was randomized to review 1 of 3 forms of an etanercept-specific decision support: a long PtDA (LONG DA), a short PtDA (SHORT DA), or the manufacturer's Enbrel decision guide (Pharm Booklet). RESULTS We had 402 RA patients participate in the study (response rate, 52%). Of the patients randomized to the Pharm Booklet, 30.6% elected to initiate etanercept. Only 14.6% and 14.0% of patients who reviewed the LONG DA or SHORT DA choose to take etanercept (χ2 = 15.7; P < 0.001). Patients who reviewed the LONG DA or SHORT DA had a greater increase in knowledge about etanercept than those who reviewed the Pharm Booklet. There was no difference in decisional conflict among the groups. A logistic regression model explained 44.2% (R2 = 0.442) of patient choice to intensify therapy by initiating etanercept. The strongest predictor of choice to intensify therapy were beliefs about etanercept's ability to improve symptoms (OR = 2.56, 96%CI [1.71, 3.80]), and its use by others like the respondent (OR = 2.24, 95%CI [1.49, 3.35]). Mediation analysis confirmed the presence of a partial mediating effect of decision support on patients' intent to take etanercept (OR = 0.59, 95%CI [0.39, 0.89]). CONCLUSIONS Patients supported by the Pharm Booklet were twice as likely to choose to intensify therapy. The Pharm Booklet's effects are partially mediated through persuasive communication techniques that influence patients' beliefs that symptoms will improve, and increase social normative beliefs, rather than by increasing the relevant knowledge, clarifying patient values about positive or negative treatment outcomes, or increasing their self-efficacy.
منابع مشابه
Undifferentiated arthritis: predictive factors of persistent arthritis and treatment decisions
A number of patients with inflammatory arthritis due to inadequate clinical or laboratory data do not fulfill diagnostic criteria for a clinical disease categories. These patients with initial diagnosis of undifferentiated arthritis (UA) may remit or progress to a definite well- defined condition such as rheumatoid arthritis (RA) or remain as UA with persistence of inflammatory arthritis. The m...
متن کاملEffects of Rheumatoid Arthritis on the Larynx
Introduction: The aim of the present study was to compare the videolaryngostroboscopic findings between patients with rheumatoid arthritis and vocally healthy controls. Materials and Methods: This case-control descriptive study was performed on 113 people, including 50 patients with rheumatoid arthritis and 63 controls. The participants were subjected to videolaryngost...
متن کاملThe Effect of Decision Aid's Pakage in Selected Treatment by Patients with Early Stage Breast Cancer and Decision making Outcomes
Background & Objectives: One of the basic principle of the protection of the patient, the patient's right to make decisions for their health. In this study, the effect of using decision aid's package was studied on choice of treatment and decision making outcomes in patients with early-stage breast cancer. Materials and Methods: This research is a clinical trial, performed on 30 patients with ...
متن کاملHistological assessment of intera articular injection of 90Y- hydroxyapatite radiocolloid in enrofloxacin induced rheumatoid arthritis in rat models
Histological assessment of intera articular injection of 90Y- hydroxyapatite radiocolloid in enrofloxacin induced rheumatoid arthritis in rat models Introduction: Rheumatoid arthritis (RA) is one of the most common and disabling diseases in societies that causes chronic synovial inflammation and joint damages. Several pharmaceutical and non-pharmaceutical treatments of RA have been developed...
متن کاملSulfasalazine plus Chloroquine-Induced Mood Disorder in a Patient with Rheumatoid Arthritis
Rheumatoid arthritis is a chronic systemic inflammatory disease that affects approximately 0.5-1% of the world population. The current approach to this disease is to start an intensive treatment without delay once the disease has developed. Various studies in the literature have shown that combination of disease modifying antirheumatic drugs such as sulfasalazine and chloroquine offers a more a...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 37 شماره
صفحات -
تاریخ انتشار 2017