What outcomes from pharmacological treatments are important to people with rheumatoid arthritis? Creating the basis of a patient core set
Sanderson, T., Morris, M., Calnan, M., Richards, P. and Hewlett, S. (2010) What outcomes from pharmacological treatments are important to people with rheumatoid arthritis? Creating the basis of a patient core set. Arthritis Care & Research, 62 (5). pp. 640-646. ISSN 0004-3591
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Publisher's URL: http://dx.doi.org/10.1002/acr.20034
Background: Function, patient global assessment and pain are routinely measured in rheumatoid arthritis (RA) clinical trials. However, other patient-reported outcomes identified as important to patients in qualitative studies, such as fatigue and quality of life, are commonly not included, and modern treatment regimens may have changed patients’ expectations of treatment outcomes. Objective: To elicit patient priority treatment outcomes for pharmacological interventions since the common use of anti-TNF therapy, which will form the basis of a core set of patient priorities to complement existing professional core sets. Methods: In-depth interviews were conducted with 23 RA patients, purposively sampled for age, gender, medication (anti-TNF or other DMARDs), disease severity and work status. Grounded Theory guided iterative data collection and analysis. Coding of the data was peer reviewed. A patient research partner collaborated in the research design and analysis. Results: 63 different outcomes important to patients were generated from the interviews. Four major categories of patient outcomes from pharmacological treatments were developed: ‘RA under control’, ‘Doing things’, ‘Emotional health’, and ‘Coping with illness’. The core category (or overall theme) was ‘Minimising the personal impact of RA’. Conclusion: Although the routine outcomes of pain, function and overall well-being were raised by patients, they also generated a further 60 important outcomes that they look for from treatment. This difference in perspective may potentially influence treatment decisions. The next step is therefore to use these data to develop a patient core set.