OBJECTIVES : Rheumatoid arthritis affects 1.5 million adults in the U.S. and results in inflammation causing pain, joint damage, and loss of function. The course of the disease is highly dynamic and individualized, and yet clinicians and patients rarely discuss treatment preferences during clinical care which means many patients struggle with adherence to therapy. To assist in the delivery of high-value care, the objective of this study was to determine patient treatment preferences related to pain, joint damage, physical changes and fatigue, and whether preferences changed over time.

METHODS : A prospective, longitudinal, survey design was used. Consenting participants who presented with RA (either rheumatoid factor positive or anti-cyclic citrullinated peptide positive) at a rheumatology clinic within the southeastern U.S. received an electronically administered, survey to identify their preferences across the four patient-valued domains of pain, joint damage, physical changes, and fatigue at their index office visit and at each subsequent office visit from October 2017 to December 2018. Preference patterns were assessed using direct-weighing methodology that is determined by the way participants allocated 100 points across domains. Demographics were collected.

RESULTS : The 113 participants were mostly Caucasian women with an average age of 55 years. 64 unique preference patterns emerged; the most prevalent pattern (27.4% of reported patterns) had patients place equal weight across each of the four domains. Overtime, 30.9% of participants reported at least one change in preference patterns, with 11.5% changing preferences 2 or more times.

CONCLUSIONS : Given the variation of patient preferences, rheumatologists need to regularly solicit individualized preferences for use in treatment selection discussions. Integrating preferences into treatment discussions may ultimately improve patient satisfaction with treatment, adherence, and functional outcomes.