Patients' Considerations in the Decision-Making Process of Initiating Disease-Modifying Antirheumatic Drugs

Ingrid Nota*, Constance H.C. Drossaert, Erik Taal, Mart A.F.J. van de Laar

*Corresponding author for this work

    Research output: Contribution to journalArticleAcademicpeer-review

    22 Citations (Scopus)
    67 Downloads (Pure)

    Abstract

    Objective
    To explore what considerations patients have when deciding about disease-modifying antirheumatic drugs (DMARDs) and what information patients need to participate in the decision-making process.

    Methods
    In-depth face-to-face interviews were conducted with 32 patients with inflammatory arthritis who recently consulted their rheumatologist and discussed initiating DMARDs.

    Results
    Beliefs in the necessity of DMARDs, either for relief of symptoms or prevention of future joint damage, were reasons to initiate DMARDs. Furthermore, trust in the rheumatologist and the health care system was important in this respect. Patients expressed many concerns about initiating DMARDS. These related to the perceived aggressive and harmful nature of DMARDs, potential (or unknown) side effects, influence on fertility and pregnancy, combination with other medicines, time to benefit, and manner of administration. Participants also worried about the future regarding long-term medication use and drug dependency, and if a medicine proved to be ineffective, about the risks of future treatments and running out of options. To decrease uncertainty, participants wanted to be informed about multiple treatment options, both current and future. They not only wanted clinical information but also information on how the medications could affect their daily lives.

    Conclusion
    Health education should inform patients about multiple treatment options, for the present as well as for the future. It should enable patients to compare treatments with regard to both clinical aspects as well as possible consequences for their daily lives.
    Original languageEnglish
    Pages (from-to)956-964
    Number of pages9
    JournalArthritis care & research
    Volume67
    Issue number7
    Early online date10 Dec 2014
    DOIs
    Publication statusPublished - Jul 2015

    Keywords

    • 2023 OA procedure

    Fingerprint

    Dive into the research topics of 'Patients' Considerations in the Decision-Making Process of Initiating Disease-Modifying Antirheumatic Drugs'. Together they form a unique fingerprint.

    Cite this