Surveyed RA Patients Value Treatment Convenience Over Safety, Efficacy

July 10, 2014
Rita Baron-Faust

An online survey suggests that rheumatoid arthritis (RA) patients want quicker, less frequent treatments even if the trade-offs are adverse reactions or less efficacy.

Poulos C, Hauber AB, Gonzalez JM, Turpcu A. Patients' Willingness to Trade Off Between the Duration and Frequency of Rheumatoid Arthritis Treatments. Arthritis Care & Research. (2014) 66: 1008–1015. Article first published online: 26 June. doi: 10.1002/acr.22265

Evidence from an online survey suggests how rheumatoid arthritis (RA) patients view the trade-offs inherent in taking their medications. Apparently they place a considerably higher value on the duration or frequency of treatmentthan they do on the risk of either mild or serious reactions or even the effectiveness of the treatment. 

The online survey of almost 900 patients (most of them white women over age 45) finds six times as many would be willing to trade a one-hour reduction in treatment time for an increase in treatment frequency of two times a year. The relative preference for the trade-off was five times greater -- even if a medication produced a lesser response.

Patients also say they’d make the trade-off even if a treatment caused an immediate mild or serious treatment reaction.

That sounds like a bad bargain, but evidence shows that reductions in medication duration or frequency improve adherence and health outcomes. Survey results indicate that the relative preferences for treatment duration depended on the level of annual treatment frequency and vice versa.

A majority of the respondents (70%) reported having severe RA, with scores of 12 or higher on the 30-point Routine Assessment of Patient Index Data version 3 (RAPID-3), encompassing pain, function, and overall well-being. Around a third (31%) had RAPID-3 scores of six or greater, indicating moderate to severe RA.

At the time of the survey, 76% of the patients were taking oral medications, while 30% had regular injections and 17% received regular infusions. Survey responses indicated that they prefer injections taken at home to infusions in a doctor’s office or clinic.

More than half were not working due to disability (31.8%) or retirement (24%), while a third were still employed.