Late Breaking Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction:
Management of rheumatoid arthritis (RA) requires monitoring and potential multiple adjustments of disease-modifying antirheumatic drugs (DMARDs) therapy to achieve disease control. As part of this process, it is unclear how patients assess the benefits and risks of DMARDs at different stages of their disease journey.
Research Question or Hypothesis:
To elicit RA patients’ preferences for attributes of DMARDs and evaluate the changes of these preferences across the disease journey.
Study Design:
Single-center cross-sectional study, using multidimensional unfolding approach.
Methods:
RA patients from the Princess Alexandra Hospital, Brisbane, Australia were asked to rank DMARDs attributes according to importance for them personally. Attributes included: RA overall disease improvement, RA symptoms and functional improvement, risk of serious infections, risk of other serious side effects, and route and frequency of administration. Sub-group analysis versus the overall cohort was performed according to three predefined dimensions of disease journey: disease duration, disease severity, and previous treatment experience.
Results:
62 patients were included; mean age was 53 years and 66% were female. RA disease improvement was the most important attribute for the overall cohort (50%), followed by symptoms and functional improvement (21%), risk of serious side effects (19%), and risk of serious infections (8%). Route and frequency of administration was the least important attribute (2%). The risk of serious side effects was the most important attribute for participants with early RA (50%, p=0.033 versus overall cohort). It was also highly ranked by treatment-naïve participants (38%, p=0.039 versus overall cohort). For participants with low disease activity, RA symptoms and functional improvement was highly preferred (36%, p= 0.041 versus overall cohort).
Conclusion:
RA patients’ perspectives and risk tolerance change across their disease journey. Patients in early RA are particularly risk averse and may miss the narrow therapeutic window. Pharmacists are ideally positioned to provide targeted education for such patients about the safety profile of their prescribed DMARDs.
Presenting Author
Hiba EL Masri PharmDUniversity of Queensland
Authors
Helen Benham MD, PhD
Princess Alexandra Hospital
Treasure McGuire BPharm, PhD
The university of Queensland
Samantha Hollingworth PhD
University of Queensland
Mieke van Driel MD, PhD
The University of Queensland