Past Coverage of ACR 2015Past Coverage of ACR 2015 Return To RheumReports Home

 

RA Patients Prefer a T2T Strategy so STOP Using Their Preference as an Excuse to Good Care!

November 9 2015 2:00 PM ET via RheumReports RheumReports

Several presentations at the ACR were about treatment decisions in RA. We are all aware of treat-to-target (T2T) following various parameters and if you treat to a target, more patients get to the target than if you don't have a target. In a large survey of 307 rheumatologists and 2536 patients, Peter Taylor found that only half used a T2T approach (abstract #430). Interestingly, he found that patients with RA were more satisfied if a T2T approach was used by their doctor. This is one more reason why we should have a targeted approach but standardization of a target in clinical practice is lacking, likely due to the discordance of a composite score and an MD assessment. Doctors seemed to be less satisfied with disease control in early RA, which could be due to trying to obtain the holy grail target of remission, whereas in established RA low disease activity may be the usual target. Targets were divided into aspirational (remission), pragmatic (other than remission) and no T2T.

What is the relevance of this research?

1. Half the docs surveyed do not use a T2T approach, so there is a care gap, as a targeted approach gets more patients to that target (as is shown in all research)!

2. Perhaps this is due to lack of adoption of a target that reflects active RA and is feasible.

3. Patients prefer a targeted approach when asked, so we can't use the status quo argument of 'My patients do not want to change therapy as they are OK right now...' This excuse doesn't ring true when patients are asked to provide input. Maybe we have to communicate our goals to patients for buy-in to a better disease state, as patients prefer goal-oriented treatment.


Share This Report


About the Author

Dr. Janet Pope
Dr. Janet Pope

Dr. Janet Pope is Professor of Medicine at Western University and Division Head of Rheumatology. Dr. Pope's research interests include epidemiologic studies in scleroderma, classification criteria in systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis.

View Full Bio

Trending Reports From ACR 2015