PMS112 - PATIENT AND RHEUMATOLOGIST PREFERENCES FOR THE ATTRIBUTES OF RHEUMATOID ARTHRITIS TREATMENTS IN SPAIN. A DISCRETE CHOICE EXPERIMENT

Abstract

Involving patients and incorporating their preferences in healthcare decision-making can contribute to treatment success. This study determinates the preferences of patients and rheumatologists for the attributes of rheumatoid arthritis (RA) treatments in Spain and evaluates patients’ preferences for shared decision-making (SDM). Preferences were determined using a discrete choice experiment (DCE). A literature review and 2 focus groups (patients=5; rheumatologists=4) were conducted to identify the attributes and levels to be included in the DCE. Seven attributes containing 2-4 levels of response were presented in 8 different scenarios. The relative importance (RI) given by rheumatologists and patients to the attributes were estimated using conditional logit model. Patient preferences for SDM were reported through an ad-hoc questionnaire. A total of 90 rheumatologists [professional exercise (years): 18.11 (SD:9.02), number of RA patients visited/week: 24.40 (SD:15.33)]; and 137 patients [83.94% female, age (years): 47.45 (SD:10.73), time since diagnosis (years): 14.23 (SD:11.78), time on current treatment (years): 6.20 (SD:7.82), HAQ score: 1.19 (SD:0.68)] participated in the study. The estimated RI were: mode of administration: R:25.23%, P:25.00%; time in optimal quality of life: R:23.41%, P:35.05%; time to onset of treatment action: R:16.24%, P:13.56%; substantial improvement in symptoms: R:13.15%, P:3.62%; severe adverse events: R:10.89%, P:11.20%; added cost for treatment: R:6.93%, P:10.66%; and mild adverse effects: R:4.16%, P:0.91%. Regarding SDM, 31.85% of the patients reported that they evaluated the therapeutic options with their doctor, who made the final decision. 37.50% indicated that they would like to decide their treatment after evaluating the different options with the doctor. For rheumatologists, in addition to efficacy, treatment mode of administration and its time to onset the action are decision-making drivers. For patients, the mode of administration and the efficacy (time in optimal quality of life) are determinants in treatment selection. Patients would prefer more involvement in treatment decisions-making.