During the 2017 European League Against Rheumatism (EULAR) Annual Congress, Leslie Harrold, MD, MPH, Associate Professor of Orthopedics and Physical Rehabilitation at the University of Massachusetts Medical School and colleagues (including researchers from the online patient community CreakyJoints®), described a study to understand RA patients' goals to manage acute RA flares and long-term disease as well as the barriers (or not) of achieving those goals.
Twenty-seven participants were interviewed utilizing open-ended questions about disease impact, disease beliefs and behaviors, medication use, provider relationship and communication, availability of insurance coverage, and community resources.
The most common participant goal was to improve or maintain physical function, but barriers to effective management included a lack of knowledge regarding how to manage flares, a reluctance to change or use medications (related to concerns about potential side effects),and limited understanding of the potential benefits.
In addition, patients reported inadequate communication between patient and provider, specifically in relation to flare management, and difficulty navigating insurance and affording medications. Those with the best outcomes reported having incorporated non-medication approaches to disease management, a willingness to initiate the conversation with their provider about changing medications, and trust in their provider.
Having reviewed barriers and facilitators experienced by RA patients to achieve treatment goals, the researchers concluded that there is a lack of shared decision-making between patients and providers.