Treatment Satisfaction, Patient Preferences, and the Impact of Suboptimal Disease Control in a Large International Rheumatoid Arthritis Cohort: SENSE Study

Peter C Taylor, Codrina Ancuta, Orsolya Nagy, María C de la Vega, Andrey Gordeev, Radka Janková, Umut Kalyoncu, Ivan Lagunes-Galindo, Jadranka Morović-Vergles, Mariana Peixoto G U E Silva de Souza, Bernadette Rojkovich, Prodromos Sidiropoulos, Atsushi Kawakami, Peter C Taylor, Codrina Ancuta, Orsolya Nagy, María C de la Vega, Andrey Gordeev, Radka Janková, Umut Kalyoncu, Ivan Lagunes-Galindo, Jadranka Morović-Vergles, Mariana Peixoto G U E Silva de Souza, Bernadette Rojkovich, Prodromos Sidiropoulos, Atsushi Kawakami

Abstract

Background: Patients' needs and perspectives are important determinants of treatment success in rheumatoid arthritis (RA). Assessing patients' perspectives can help identify unmet needs and enhance the understanding of treatment benefits.

Objective: The SENSE study assessed the impact of inadequate response to disease-modifying antirheumatic drugs (DMARDs) on treatment satisfaction, disease outcomes, and patient perspectives related to RA disease management.

Methods: SENSE was a noninterventional, cross-sectional study conducted in 18 countries across Europe, Asia, and South America. Adult patients with poorly controlled RA of moderate/high disease activity were eligible. Patient satisfaction was assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM v1.4). Treatment adherence, healthcare resource utilization (HRU), quality of life (QoL), work ability, digital health literacy (DHL), patient preference information, and treatment strategy were also assessed.

Results: A total of 1624 patients were included in the study: most were female (84.2%) and middle-aged, and mean disease duration was 10.5 years. Mean TSQM global satisfaction subscore was 60.9, with only 13.5% of patients reporting good treatment satisfaction (TSQM global ≥80). The strongest predictor of good treatment satisfaction was treatment with advanced therapies. Most patients (87.4%) reported good treatment adherence. In general, patients had impaired QoL and work ability, high HRU, and 67.4% had poor DHL. Leading treatment expectations were "general improvement of arthritis" and "less joint pain". Most patients preferred oral RA medications (60.7%) and rapid (≤1 week) onset of action (71.1%). "Increased risk for malignancies" and "increased risk for cardiovascular disease" were the least acceptable side effects. Despite suboptimal control, advanced therapies were only used in a minority of patients, and DMARD switches were planned for only half of the patients.

Conclusion: Suboptimal disease control negatively impacts treatment satisfaction, work ability, QoL, and HRU. Data collected on patient perspectives may inform shared decision-making and optimize treat-to-target strategies for improving patient outcomes in RA.

Keywords: adherence; digital health literacy; patient preference; rheumatoid arthritis; treatment satisfaction.

Conflict of interest statement

Peter C. Taylor received research grants, consultation, and/or speaking fees from AbbVie, Biogen, Bristol-Myers Squibb, Celgene, Celltrion, Fresenius, Galapagos, Gilead, GSK, Janssen, Eli Lilly, Sanofi, Nordic Pharma, Novartis, Pfizer, Roche, and UCB; Codrina Ancuta received consultation and/or speaker fees from AbbVie, Eli Lilly, Ewopharma, Merck Sharpe and Dohme, Novartis, Pfizer, Roche, and UCB; Andrey Gordeev received speaker fees from AbbVie; Radka Janková received speaker fees from AbbVie, Bristol-Myers Squibb, Eli Lilly, Merck Sharpe and Dohme, Pfizer, Roche, Sanofi, and UCB; Umut Kalyoncu received consultation and/or speaker fees from AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, Roche, and UCB; Jadranka Morović-Vergles received speaker fees from AbbVie, Eli Lilly, Ewopharma, Merck Sharpe and Dohme, Novartis, Pfizer, Roche, and UCB; Mariana Peixoto G. U. e Silva de Souza received research grants from AbbVie, Bristol-Myers Squibb, GSK, Pfizer, and UCB; honoraria for consultancies and/or speaking engagements from AbbVie, Janssen, Pfizer, Roche, and UCB; and is a Member of RA commission – Brazilian Society of Rheumatology and vice-president of SMR (Regional Society of Rheumatology); Prodromos Sidiropoulos received research grants, consultation, and/or speaking fees from AbbVie, Amgen, MSD, Novartis, Pfizer, Roche, and UCB; Atsushi Kawakami received speaker fees from AbbVie GK., Actelion Pharmaceuticals Japan Ltd., Asahi Kasei Pharma Corporation., Astellas Pharma Inc, Celltrion Healthcare Co., Ltd., Chugai Pharmaceutical Co., Daiichi Sankyo Co., Eisai Co., Eli Lilly Japan, GlaxoSmithKline K.K., Janssen Pharmaceutical K.K., Kowa Co., Ltd., MedPeer Inc, Mitsubishi Tanabe Pharma Co., Novartis Pharma Inc, ONO Pharmaceutical Co., Taisho Pharma Co., Ltd., Takeda Pharmaceutical Co., Ltd., and Pfizer Japan Inc; and grants and research support from AbbVie GK., Actelion Pharmaceuticals Japan Ltd., Asahi Kasei Pharma Corporation, Astellas Pharma Inc, AYUMI Pharmaceutical Co., Boehringer Ingelheim Japan, Bristol-Myers Squibb, Celltrion Healthcare Co., Ltd., Chugai Pharmaceutical Co., Daiichi Sankyo Co., Eisai Co., Eli Lilly Japan, Kyowa Hakko Kirin Co., MSD K.K., Neopharma Japan Co., Ltd., Novartis Pharma Inc, ONO Pharmaceutical Co., Sanofi K.K., Taisho Pharmaceutical Co., Ltd., Takeda Science Foundation, and Teijin Pharma Co. Orsolya Nagy and Ivan Lagunes-Galindo are employees of AbbVie and may own stock or options in AbbVie. No relevant conflicts of interest were declared by María C. de la Vega and Bernadette Rojkovich. The authors report no other conflicts of interest related to this work. Some of the data from this paper were presented at the EULAR 2020 Congress as a poster presentation (SAT0123). The poster’s abstract was published in the “Scientific Abstracts” section in Annals of Rheumatic Diseases (Taylor et al Ann Rheum Dis 2020; 79:996–997; https://ard.bmj.com/content/79/Suppl_1/996).

© 2021 Taylor et al.

Figures

Figure 1
Figure 1
Mode of action for planned DMARD switches.
Figure 2
Figure 2
Treatment Satisfaction Questionnaire for Medication subscores.
Figure 3
Figure 3
Patients’ expectations for RA treatments.
Figure 4
Figure 4
Patients’ preferences for RA treatments: (A) route of administration, drug combinations, and time to effect; (B) acceptability of potential side effects of RA treatments.
Figure 5
Figure 5
Patients’ need for patient support programs.

References

    1. Yu C, Jin S, Wang Y, et al. Remission rate and predictors of remission in patients with rheumatoid arthritis under treat-to-target strategy in real-world studies: a systematic review and meta-analysis. Clin Rheumatol. 2019;38(3):727–738. doi:10.1007/s10067-018-4340-7
    1. Batko B, Batko K, Krzanowski M, Żuber Z. Physician adherence to treat-to-target and practice guidelines in rheumatoid arthritis. J Clin Med. 2019;8:9. doi:10.3390/jcm8091416
    1. Louder AM, Singh A, Saverno K, et al. Patient preferences regarding rheumatoid arthritis therapies: a conjoint analysis. Am Health Drug Benefits. 2016;9(2):84–93.
    1. Ho MP, Gonzalez JM, Lerner HP, et al. Incorporating patient-preference evidence into regulatory decision making. Surg Endosc. 2015;29(10):2984–2993. doi:10.1007/s00464-014-4044-2
    1. FDA guidance: guidance on patient preference information in premarket approval applications, humanitarian device exemption applications, and de novo requests. Available from: . Accessed August24, 2016
    1. FDA guidance: patient preference study design – qualitative steps first steps for sponsors initiating a patient preference study. Available from: . Accessed November2, 2017
    1. Marengo MF, Suarez-Almazor ME. Improving treatment adherence in patients with rheumatoid arthritis: what are the options? Int J Clin Rheumatol. 2015;10(5):345–356. doi:10.2217/ijr.15.39
    1. Papadimitropoulos M, Mysler E, Garcia E, Lobosco S, Botello B, Leonardi Reyes F. Treatment patterns and satisfaction for rheumatoid arthritis patients in Latin America undergoing advanced therapy. Value Health. 2017;20(9):PA891.
    1. Schäfer M, Albrecht K, Kekow J, et al. Factors associated with treatment satisfaction in patients with rheumatoid arthritis: data from the biological register RABBIT. RMD Open. 2020;6:3. doi:10.1136/rmdopen-2020-001290
    1. Jackson JL, Chamberlin J, Kroenke K. Predictors of patient satisfaction. Soc Sci Med. 2001;52(4):609–620. doi:10.1016/S0277-9536(00)00164-7
    1. Smolen JS, Aletaha D. What should be our treatment goal in rheumatoid arthritis today? Clin Exp Rheumatol. 2006;24(6 Suppl 43):S-7–13.
    1. Van den Bosch F, Ostor AJK, Wassenberg S, et al. Impact of participation in the adalimumab (humira) patient support program on rheumatoid arthritis treatment course: results from the passion study. Rheumatol Ther. 2017;4(1):85–96. doi:10.1007/s40744-017-0061-7
    1. Norman CD, Skinner HA. eHealth literacy: essential skills for consumer health in a networked world. J Med Internet Res. 2006;8(2):e9. doi:10.2196/jmir.8.2.e9
    1. Durand C, Eldoma M, Marshall DA, Bansback N, Hazlewood GS. Patient preferences for disease-modifying antirheumatic drug treatment in rheumatoid arthritis: a systematic review. J Rheumatol. 2020;47(2):176–187. doi:10.3899/jrheum.181165
    1. Radawski C, Genovese MC, Hauber B, et al. Patient perceptions of unmet medical need in rheumatoid arthritis: a cross-sectional survey in the USA. Rheumatol Ther. 2019;6(3):461–471. doi:10.1007/s40744-019-00168-5
    1. Alten R, Krüger K, Rellecke J, et al. Examining patient preferences in the treatment of rheumatoid arthritis using a discrete-choice approach. Patient Prefer Adherence. 2016;10:2217–2228. doi:10.2147/PPA.S117774
    1. Webster K, Cella D, Yost K. The Functional Assessment of Chronic Illness Therapy (FACIT) Measurement System: properties, applications, and interpretation. Health Qual Life Outcomes. 2003;1:79. doi:10.1186/1477-7525-1-79
    1. Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23(2):137–145. doi:10.1002/art.1780230202
    1. Ware JE Jr, Sherbourne CD, The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–483. doi:10.1097/00005650-199206000-00002
    1. Zhang W, Bansback N, Boonen A, Young A, Singh A, Anis AH. Validity of the work productivity and activity impairment questionnaire–general health version in patients with rheumatoid arthritis. Arthritis Res Ther. 2010;12(5):R177. doi:10.1186/ar3141
    1. Walsh JC, Mandalia S, Gazzard BG. Responses to a 1 month self-report on adherence to antiretroviral therapy are consistent with electronic data and virological treatment outcome. Aids. 2002;16(2):269–277. doi:10.1097/00002030-200201250-00017
    1. De Cuyper E, De Gucht V, Maes S, Van Camp Y, De Clerck LS. Determinants of methotrexate adherence in rheumatoid arthritis patients. Clin Rheumatol. 2016;35(5):1335–1339. doi:10.1007/s10067-016-3182-4
    1. Karve S, Cleves MA, Helm M, Hudson TJ, West DS, Martin BC. Good and poor adherence: optimal cut-point for adherence measures using administrative claims data. Curr Med Res Opin. 2009;25(9):2303–2310. doi:10.1185/03007990903126833
    1. Richtering SS, Hyun K, Neubeck L, et al. eHealth literacy: predictors in a population with moderate-to-high cardiovascular risk. JMIR Hum Factors. 2017;4(1):e4. doi:10.2196/humanfactors.6217
    1. Fayad F, Ziade NR, Merheb G, et al. Patient preferences for rheumatoid arthritis treatments: results from the national cross-sectional LERACS study. Patient Prefer Adherence. 2018;12:1619–1625. doi:10.2147/PPA.S168738
    1. Marshall D, Bridges JF, Hauber B, et al. Conjoint analysis applications in health - how are studies being designed and reported?: an update on current practice in the published literature between 2005 and 2008. Patient. 2010;3(4):249–256. doi:10.2165/11539650-000000000-00000
    1. Jobanputra P, Maggs F, Deeming A, et al. A randomised efficacy and discontinuation study of etanercept versus adalimumab (RED SEA) for rheumatoid arthritis: a pragmatic, unblinded, non-inferiority study of first TNF inhibitor use: outcomes over 2 years. BMJ Open. 2012;2:6. doi:10.1136/bmjopen-2012-001395
    1. Mahlich J, Schaede U, Sruamsiri R. Shared decision-making and patient satisfaction in Japanese rheumatoid arthritis patients: a new “preference fit” framework for treatment assessment. Rheumatol Ther. 2019;6(2):269–283. doi:10.1007/s40744-019-0156-4
    1. Hueston WJ, Mainous AG 3rd, Schilling R. Patients with personality disorders: functional status, health care utilization, and satisfaction with care. J Fam Pract. 1996;42(1):54–60.
    1. Wyshak G, Barsky A. Satisfaction with and effectiveness of medical care in relation to anxiety and depression. Patient and physician ratings compared. Gen Hosp Psychiatry. 1995;17(2):108–114. doi:10.1016/0163-8343(94)00097-W
    1. Stark JL, Yassine M, Nowell WB, et al. THU0159 Barriers to rheumatoid arthritis treatment optimisation: real-world data from the arthritispower registry. Ann Rheum Dis. 2018;77(Suppl 2):299.
    1. Singh JA, Saag KG, Bridges SL Jr, et al. 2015 American College of rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2016;68(1):1–25. doi:10.1002/acr.22783
    1. Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2020;79(6):685–699. doi:10.1136/annrheumdis-2019-216655
    1. Yun H, Chen L, Xie F, et al. Do patients with moderate or high disease activity escalate rheumatoid arthritis therapy according to treat-to-target principles? Results from the rheumatology informatics system for effectiveness registry of the American College of Rheumatology. Arthritis Care Res. 2020;72(2):166–175. doi:10.1002/acr.24083
    1. Solomon DH, Bitton A, Katz JN, Radner H, Brown EM, Fraenkel L. Review: treat to target in rheumatoid arthritis: fact, fiction, or hypothesis? Arthritis Rheumatol. 2014;66(4):775–782. doi:10.1002/art.38323
    1. Fleischmann RM, van der Heijde D, Gardiner PV, Szumski A, Marshall L, Bananis E. DAS28-CRP and DAS28-ESR cut-offs for high disease activity in rheumatoid arthritis are not interchangeable. RMD Open. 2017;3(1):e000382. doi:10.1136/rmdopen-2016-000382
    1. Smolen JS, Gladman D, McNeil HP, et al. Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study. RMD Open. 2019;5(1):e000585. doi:10.1136/rmdopen-2017-000585
    1. Murage MJ, Tongbram V, Feldman SR, et al. Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient Prefer Adherence. 2018;12:1483–1503. doi:10.2147/PPA.S167508
    1. Taylor PC, Alten R, Gomez-Reino JJ, et al. Clinical characteristics and patient-reported outcomes in patients with inadequately controlled rheumatoid arthritis despite ongoing treatment. RMD Open. 2018;4(1):e000615. doi:10.1136/rmdopen-2017-000615
    1. van Vilsteren M, Boot CR, Knol DL, et al. Productivity at work and quality of life in patients with rheumatoid arthritis. BMC Musculoskelet Disord. 2015;16:107. doi:10.1186/s12891-015-0562-x
    1. Xavier RM, Zerbini CAF, Pollak DF, et al. Burden of rheumatoid arthritis on patients’ work productivity and quality of life. Adv Rheumatol. 2019;59(1):47. doi:10.1186/s42358-019-0090-8
    1. Fraenkel L, Bogardus S, Concato J, Felson D. Unwillingness of rheumatoid arthritis patients to risk adverse effects. Rheumatology. 2002;41(3):253–261. doi:10.1093/rheumatology/41.3.253
    1. Kim H, Xie B. Health literacy in the eHealth era: A systematic review of the literature. Patient Educ Couns. 2017;100(6):1073–1082. doi:10.1016/j.pec.2017.01.015
    1. van der Vaart R, Drossaert CH, de Heus M, Taal E. van de Laar MA. Measuring actual eHealth literacy among patients with rheumatic diseases: a qualitative analysis of problems encountered using Health 1.0 and Health 2.0 applications. J Med Internet Res. 2013;15(2):e27.

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