Preference for involvement in treatment decision-making for Japanese rheumatoid arthritis patients: A questionnaire survey / 日本プライマリ・ケア連合学会誌

ABSTRACT

Introduction: Recently, the significance of “shared decision-making” in which patients were actively involved in decision options for treatment on the basis of informed consent, has been recognized. However, few studies concerning this issue have been reported regarding rheumatoid arthritis (RA). We conducted a questionnaire survey on patient involvement in treatment decision-making. <br>Methods: Five hundred RA patients who attended the May 2009 annual meeting of the RA Patient Association in Japan were enrolled in this study. A questionnaire included disease activity and severity, and preferences regarding the extent of patient involvement in deciding on treatment options. Desired and actual roles were chosen from the following descriptions #1 I prefer to leave all decisions regarding treatment to my doctor. #2 I prefer my doctor to make the final decision after showing me the best option. #3 I prefer that my doctor makes the final decision after showing me all possible therapeutic options. #4 I prefer that my doctor and I share responsibility for deciding which treatment is best for me. And #5 I prefer that the decision about which treatment I will receive should be made by myself. <br>Results: The questionnaire was returned by 76.4% of the patients, 91% of whom were women, and 71% were 60 years of age or older. While 54% of the patients selected “#4” as their desired role in the decision-making process, 44% of them indicated that “#3” was their actual role, indicating that they accepted the opinion of the attending physician. The desired role was concordant with the actual role in 45% of the patients, who were more satisfied with their medical care and relied on the physician more than those whose desired and actual roles were in conflict. <br>Conclusion: The physician should assess individual patient preferences and tailor care accordingly.