Rheumatologists´ Perspective on Patient Reported Outcomes to Promote Shared Decision-Making in Patients With Rheumatoid Arthritis

Speaker(s)

Rubio E1, Moreno MJ2, Gallego A3, Castrejon I4, Cobo A5, Moyano S6, Comellas Serra M7
1Hospital Universitario Virgen del Rocio, Sevilla, Spain, 2Hospital Rafael Méndez, Lorca, Spain, 3Hospital Perpetuo Socorro, Badajoz, Spain, 4Hospital General Universitario Gregorio Marañón, Madrid, Spain, 5Eli Lilly and company, Madrid, Spain, 6Eli Lilly and company, Alcobendas, Spain, 7Outcomes 10, Castellon de la plana , CS, Spain

Presentation Documents

OBJECTIVES: Rheumatoid arthritis (RA) has an important impact on patients, both in physical function and quality of life. Incorporating the patient's perspective in clinical decisions is key to optimizing long-term outcomes. We aim to explore Spanish rheumatologists´ experience and perspective on Patient Reported Outcomes (PROs) and shared decision-making (SDM) in routine care.

METHODS: Two round-Delphi were conducted. Panelists’ perception of patient involvement and PROs' appropriateness and feasibility was assessed on a 7-point Likert scale. The consensus was reached when ≥75% agreed (6-7) or disagreed (1-2). Items for which consensus was not achieved were included in the 2nd round. A scientific Committee including 4 expert rheumatologists led the project.

RESULTS:

39 rheumatologists (83% response rate) completed the 1st round [38.5% men; mean age 50.3 (SD:11.0) years; 23.1% in charge of a monographic RA clinic; mean 18.1 (SD:9.6) years experience]. Of them, 33 (85%) completed the 2nd.

Although 82.1% of rheumatologists agreed on involving patients in therapeutic decision-making to improve adherence, only 56.4% include an SDM strategy in treatment decisions.

79.4% agreed on the importance of incorporating PROs in routine care but only 28.2% use them to assess disease activity. The main reason is the lack of feasibility (36.3%). Only 38.5% of panelists incorporate the result of PROs to select the most appropriate therapy, not reaching a consensus regarding either its appropriateness (66.6%) or feasibility (30.3%). 87.1% agreed that the information provided by PROs should be interpreted according to patients' characteristics and comorbidity. 75.7% considered that the information provided by PROs is useful not only in patients on biologics but also with conventional treatment.

CONCLUSIONS: Panelists consider PROs useful to guide SDM in clinical practice however the actual implementation is scarce. To move toward patient-centered care, efforts should be made to enhance the use of PROs and raise awareness of their importance in optimizing outcomes.

Code

PCR69

Topic

Patient-Centered Research

Topic Subcategory

Patient-reported Outcomes & Quality of Life Outcomes

Disease

No Additional Disease & Conditions/Specialized Treatment Areas