PMID- 17726671
OWN - NLM
STAT- MEDLINE
DCOM- 20080617
LR  - 20220321
IS  - 1478-2189 (Print)
IS  - 1478-2189 (Linking)
VI  - 6
IP  - 1
DP  - 2008 Mar
TI  - Treatment choices, preferences and decision-making by patients with rheumatoid 
      arthritis.
PG  - 1-14
AB  - OBJECTIVES: To explore rheumatoid arthritis (RA) patient treatment preferences, 
      their decision-making and the treatment choices they would make when faced with 
      three anti-tumour necrosis factor-alpha (TNF-alpha) therapy options. METHODS: Two 
      methods of enquiry were used: postal questionnaire and one-to-one interviews. RA 
      patients not taking anti-TNF-alpha medications were asked to complete a 
      questionnaire after reading a written scenario, which involved choosing and 
      identifying factors that influenced their treatment choice from three 
      anti-TNF-alpha therapies: etanercept (Enbrel), adalimumab (Humira) and infliximab 
      (Remicade). Patients who had tried more than one anti-TNF-alpha medication were 
      asked at one-to-one interviews for their treatment preferences and how their 
      current treatment had been decided. RESULTS: Both interviewees and questionnaire 
      respondents chose adalimumab as their preferred treatment. Interviewees 
      identified lack of control, convenience and technical issues as influencing 
      treatment choice. Questionnaire respondents were less likely than interviewees to 
      want to participate in making decisions about the selection of anti-TNF-alpha 
      therapy. There were few gender differences. Patients younger than 61 years old 
      were more confident about self-administering treatment, and preferred 
      subcutaneous (sc) over intravenous (iv) medication, as this reduced regular 
      hospital attendance. Older patients preferred health care staff to administer 
      treatment and more readily identified 'contact with other patients/meeting 
      others' and 'staff availability if problems arise' as factors influencing choice. 
      CONCLUSIONS: RA patients demonstrate a clear treatment preference. Different 
      factors influence patients who choose sc compared with iv medications. Many RA 
      patients either wished to share in treatment decisions or relinquish 
      responsibility to the health professional when choosing anti-TNF-alpha therapy. 
      Patients require reassurance and continuing dialogue with clinicians to manage 
      their condition optimally.
FAU - Chilton, Frances
AU  - Chilton F
AD  - Rheumatology Department, South Warwickshire NHS Trust Hospital, Warwick, UK. 
      frances.chilton@swh.nhs.uk
FAU - Collett, Raymond A
AU  - Collett RA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Musculoskeletal Care
JT  - Musculoskeletal care
JID - 101181344
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 0 (Antirheumatic Agents)
RN  - 0 (Immunoglobulin G)
RN  - 0 (Receptors, Tumor Necrosis Factor)
RN  - B72HH48FLU (Infliximab)
RN  - FYS6T7F842 (Adalimumab)
RN  - OP401G7OJC (Etanercept)
SB  - IM
MH  - Adalimumab
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antibodies, Monoclonal/therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Antirheumatic Agents/*therapeutic use
MH  - Arthritis, Rheumatoid/*drug therapy
MH  - Chi-Square Distribution
MH  - Choice Behavior
MH  - *Decision Making
MH  - Etanercept
MH  - Female
MH  - Humans
MH  - Immunoglobulin G/therapeutic use
MH  - Infliximab
MH  - Interviews as Topic
MH  - Male
MH  - Middle Aged
MH  - *Patient Satisfaction
MH  - Receptors, Tumor Necrosis Factor/therapeutic use
MH  - Surveys and Questionnaires
MH  - Treatment Outcome
EDAT- 2007/08/30 09:00
MHDA- 2008/06/18 09:00
CRDT- 2007/08/30 09:00
PHST- 2007/08/30 09:00 [pubmed]
PHST- 2008/06/18 09:00 [medline]
PHST- 2007/08/30 09:00 [entrez]
AID - 10.1002/msc.110 [doi]
PST - ppublish
SO  - Musculoskeletal Care. 2008 Mar;6(1):1-14. doi: 10.1002/msc.110.