When treating chronic diseases, finding the right treatment can be challenging. Patients may have to try different therapies and combination of drugs before finding the most effective approach. In a recent study conducted by our research team, we were surprised to find that only one-third of people with high disease activity were offered adjustments to their treatment.
The Study: Barriers to Rheumatoid Arthritis Treatment Optimization
The study involved 257 rheumatoid arthritis patients from the ArthritisPower research registry who experienced high disease activity.
Through an online survey, we found that despite their high disease activity, only 37% were offered a treatment change at their last physician visit. Of those patients, 72% accepted the change — most of them intensified their treatment. The biggest reasons for accepting the treatment change were to reduce pain and swelling in the joints, to reduce fatigue, and to prevent damage to the joints.
W. Benjamin Nowell, Director of Patient-Centered Research at CreakyJoints and an ArthritisPower co-principal investigator, said, “It’s concerning that rheumatologists and patients may not be effectively engaging around treat-to-target goals even when symptoms, lab results, or patient-reported outcomes data reported via ArthritisPower warrant such discussion. This study suggests that people living with RA need to feel empowered to discuss and consider treatment escalation with their doctor when both agree that a change is merited.”
What should patients do?
If patients are not reaching mutually agreed goals or a desired state of remission, they should initiate a conversation with their physician.
A conversation should prompt physicians to re-evaluate the current treatment plan to determine if a change is appropriate.
Treat-to-Target is a treatment strategy where the clinician treats the patient to reach and maintain pre-determined specified and sequentially measured targets. The strategy can be simplified into a cycle of measuring, adapting treatment, measuring, adapting treatment, and so forth, until the treatment target has been achieved. One of the key principles of treat-to-target strategies is that treatment must be based on a shared decision between the patient and the physician, therefore it’s important that patients are actively engaged with their physician to make sure treatment targets are met.
Participating in Future Studies
If you’re diagnosed with RA or a musculoskeletal condition, participate in future studies like this by joining CreakyJoints’ patient research registry, ArthritisPower. As a patient-led, patient-centered initiative, our research team is committed to investigating research topics that matter most to you.