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VIDEO: Patients with RA ‘highly deferential’ to rheumatologists for treatment escalation

AMSTERDAM — Patients frequently followed their rheumatologist’s recommendations regarding treatment escalation, whereas rheumatologists commonly cited patient reluctance as the primary reason treatment changes were not made, according to data presented at the EULAR Annual Congress.

“The factors broke down differently depending on whether patients accepted a treatment change or escalation vs. scaling back treatment vs. not accepting a treatment change,” W. Benjamin Nowell, PhD, director of Patient-Centered Research at the Global Healthy Living Foundation at CreakyJoints, told Healio Rheumatology. “Across all these groups, the doctor’s recommendation had the greatest influence; however, for patients that accepted a treatment change, the primary factor was that their symptoms were still bad or were getting worse.”

He noted, “For patients who scaled back treatment, the most important factor was because the doctor had recommended it, while the second reason was due to side effects; for patients who did not change, the primary factor was because their doctor said it was acceptable to remain on the treatment.”

“It sounds like we are talking in circles, with patients saying they defer to the doctors while doctors are noting that patients are reluctant to change,” Nowell said. “I think there is an opportunity to develop more common understanding to help move toward a treat-to-target environment and help patients who are probably eligible for treatment change.”

AMSTERDAM — Patients frequently followed their rheumatologist’s recommendations regarding treatment escalation, whereas rheumatologists commonly cited patient reluctance as the primary reason treatment changes were not made, according to data presented at the EULAR Annual Congress.

“The factors broke down differently depending on whether patients accepted a treatment change or escalation vs. scaling back treatment vs. not accepting a treatment change,” W. Benjamin Nowell, PhD, director of Patient-Centered Research at the Global Healthy Living Foundation at CreakyJoints, told Healio Rheumatology. “Across all these groups, the doctor’s recommendation had the greatest influence; however, for patients that accepted a treatment change, the primary factor was that their symptoms were still bad or were getting worse.”

He noted, “For patients who scaled back treatment, the most important factor was because the doctor had recommended it, while the second reason was due to side effects; for patients who did not change, the primary factor was because their doctor said it was acceptable to remain on the treatment.”

“It sounds like we are talking in circles, with patients saying they defer to the doctors while doctors are noting that patients are reluctant to change,” Nowell said. “I think there is an opportunity to develop more common understanding to help move toward a treat-to-target environment and help patients who are probably eligible for treatment change.”

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