RESEARCH - Patient decision-making related to DMARD decisions in RA: importance of patient trust of physician

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J Rheumatol. 2008 Feb 15 [Epub ahead of print]

Patient Decision-Making Related to Antirheumatic Drugs in Rheumatoid

Arthritis: The Importance of Patient Trust of Physician.

RW, Head AJ, René J, Swartz TJ, Fiechtner JJ, McIntosh BA,

Holmes-Rovner M.

From the Departments of Medicine and Rheumatology, and the Center for

Ethics and the Humanities in the Life Sciences, College of Human

Medicine, Michigan State University, Grand Rapids, Michgan, USA.

OBJECTIVE: To explore how rheumatoid arthritis (RA) antirheumatic

drug-specific knowledge and numeric literacy, patient trust in

physician, and demographic and disease-related factors relate to the

confidence of patient decision-making related to disease modifying

antirheumatic drugs (DMARD). METHODS: Data were analyzed from 628

randomly selected patients with RA receiving care in community

rheumatology practices, who responded to a multicenter,

cross-sectional mail survey. We used multiple regression models to

predict patient confidence in DMARD decision-making related to their

most recently initiated DMARD. RESULTS: Significant positive

correlation was found between confidence in DMARD decision and trust

in physician, DMARD-specific knowledge, and disease duration, but not

risk-related numeric literacy, sex, or education. Negative

correlations were found with disease severity and current bother with

DMARD side effects. A multiple linear regression model of confidence

in DMARD decision had an overall R = 0.788, R(2) = 0.620 (p < 0.001).

The 4 dependent variables contributing significantly to the model were

female sex, Medicaid insurance status, satisfaction with RA disease

control, and trust in physician, with standardized beta = 0.077,

-0.089, 0.147, and 0.687, respectively.

CONCLUSION: In this sample of community patients with RA, the patient

trust in physician had substantially greater effect on confidence in

DMARD decision than DMARD-specific knowledge, disease-related factors,

or demographic characteristics.

PMID: 18278840

http://www.ncbi.nlm.nih.gov/pubmed/18278840

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Not an MD