Arthritis Care & Research最新文献

{"title":"Cost-Related Medication Behaviors for Patients With and Without Systemic Autoimmune Rheumatic Diseases.","authors":"Jeong Yee, Candace H Feldman, Emily G Oakes, Jack Ellrodt, Hongshu Guan, May Y Choi, Elizabeth W Karlson, Karen H Costenbader","doi":"10.1002/acr.25442","DOIUrl":"10.1002/acr.25442","url":null,"abstract":"<p><strong>Objective: </strong>Medication nonadherence challenges the management of systemic autoimmune rheumatic diseases (SARDs). We investigated cost-related medication behaviors among patients with SARDs, and compared them to those of patients without SARDs, in a large diverse cohort across the United States.</p><p><strong>Methods: </strong>As part of the All of Us (version 7), a nationwide diverse adult cohort with linked electronic health records begun in 2017, participants completed questionnaires concerning cost-related medication behaviors. Chi-square tests compared responses between patients with SARDs, by disease and medication type, and to those without SARDs. Logistic regression analyses were used to calculate odds ratios (95% confidence intervals [CIs]).</p><p><strong>Results: </strong>We analyzed data from 3,997 patients with SARDs and 73,990 participants without SARDs. After adjustment, patients with versus without SARDs had 1.56 times increased odds of reporting unaffordability of prescription medicines (95% CI 1.43-1.70), 1.43 times increased odds of cost-related medication nonadherence (95% CI 1.31-1.56), and 1.23 times increased odds of using cost-reducing strategies (95% CI 1.14-1.32). Patients with SARDs who reported unaffordability were 16.5% less likely to receive a disease-modifying drug (95% CI 0.70-0.99) but 18.1% more likely to receive glucocorticoids (95% CI 0.99-1.42). In addition, unaffordability of prescription medicines was likely to have 1.27 times increased odds of one to two emergency room visits per year (95% CI 1.03-1.57) and 1.38-fold increased odds of three or more emergency room visits per year (95% CI 0.96-1.99).</p><p><strong>Conclusion: </strong>In this large diverse cohort, patients with versus without SARDs had more self-reported cost-related medication behaviors, and those who reported medication unaffordability received fewer disease-modifying drugs and had more emergency room visits.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rheum for Improvement? Delayed Diagnosis of Juvenile Idiopathic Arthritis: A Narrative Review.","authors":"Anna Costello, Irit Rasooly, Pamela Weiss","doi":"10.1002/acr.25438","DOIUrl":"10.1002/acr.25438","url":null,"abstract":"<p><p>Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood and a disease for which we have safe and effective therapies. Early diagnosis of JIA enables timely initiation of therapy and improves long-term disease outcomes. However, many patients with JIA experience prolonged diagnostic delays and have a turbulent course to diagnosis. In this narrative review, we explore the importance of early diagnosis in JIA, what is known about time to diagnosis and diagnostic trajectory, and factors that contribute to delayed diagnosis. We also discuss next steps to improve time to diagnosis for these vulnerable patients.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preferences for Tapering Biologic Disease-Modifying Antirheumatic Drugs Among People With Rheumatoid Arthritis: A Discrete Choice Experiment.","authors":"Suz Jack Chan, Lisa K Stamp, Gareth J Treharne, Janet M Y Cheung, Nicola Dalbeth, Rebecca Grainger, Simon Stebbings, Carlo A Marra","doi":"10.1002/acr.25437","DOIUrl":"10.1002/acr.25437","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about the preferences of people with rheumatoid arthritis (RA) regarding tapering of biologic disease-modifying antirheumatic drugs (bDMARDs). The aim of this study was to assess the preferences of people with RA in relation to potential treatment-related benefits and risks of bDMARD tapering and the health care service-related attributes that affect tapering.</p><p><strong>Methods: </strong>Participants with RA who had experience taking a bDMARD completed an online discrete choice experiment. Participants were asked their preferences when given three hypothetical treatment scenarios in which varying the frequency of treatment might alter their chance of adverse effects, of regaining disease control, and of other health care service-related effects. Preference weights were estimated using a multinomial logit model.</p><p><strong>Results: </strong>There were 142 complete responses. Reduced dosing frequency of bDMARD treatment had the largest impact on preference (mean 1.0, 95% confidence interval [CI] 0.8-1.2), followed by chance of disease flare (mean 0.7, 95% CI 0.6-0.9). Participants were willing to accept an increased risk of flare between 10.6% (95% CI 3.2-17.9) and 60.6% (95% CI 48.1-72.9) in exchange for benefits associated with tapering bDMARDs. Participants with better quality of life were more likely to choose to remain on current treatment. The predicted uptake of bDMARD tapering was high among people with RA, suggesting bDMARD tapering was a favored option.</p><p><strong>Conclusion: </strong>For individuals with RA, making decisions about tapering bDMARDs involves considering several factors, with the most important determinants identified as dosing frequency and the risk of disease flare. Understanding patient perspectives of bDMARD tapering may enable physicians to make patient-focused shared health care decisions.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Pain Adaptation in Youth With Juvenile Idiopathic Arthritis: Identifying Youth and Parent Resilience Resources and Mechanisms.","authors":"Yvonne N Brandelli, Sean P Mackinnon, Christine T Chambers, Jennifer A Parker, Adam M Huber, Jennifer N Stinson, Shannon A Johnson, Jennifer P Wilson","doi":"10.1002/acr.25439","DOIUrl":"10.1002/acr.25439","url":null,"abstract":"<p><strong>Objective: </strong>Although juvenile idiopathic arthritis (JIA) is often associated with pain, this experience does not necessitate negative outcomes (eg, depression, functional impairment). Little research has explored youth and parent resilience resources (ie, stable traits) and mechanisms (ie, dynamic processes) in this context, and studies have focused on their contributions independently rather than collectively. This study, informed by the Ecological Resilience-Risk Model in Pediatric Chronic Pain, sought to (1) explore the relationships among youth and parent resilience resources and mechanisms and (2) identify the relative importance (RI; ie, independent contributions when entered simultaneously) of evidence-based youth and parent resources and mechanisms in contributing to youth-reported recovery, sustainability, and growth outcomes.</p><p><strong>Methods: </strong>Youth (13-18 years) with JIA and their parents (156 dyads) completed a battery of online questionnaires assessing resilience resources (optimism, resilience), mechanisms (psychological flexibility, pain acceptance, self-efficacy), recovery and sustainability (pain intensity, functional disability, health-related quality of life), and growth (benefit finding) outcomes.</p><p><strong>Results: </strong>Analyses demonstrated significant positive correlations across within-person resources and mechanisms and weaker correlations across within-dyad resources and mechanisms. Although the RI of predictors varied by outcome, youth pain acceptance was the most robust predictor across models (RI = 0.03-0.15). Some predictors (eg, parent psychological flexibility and pain acceptance) were generally categorized as \"Not Important,\" whereas others (eg, youth resilience) had \"Inconclusive\" results, suggesting construct overlap.</p><p><strong>Conclusion: </strong>Although additional research is needed to further understand resilience, results highlight the importance of fostering pain acceptance in youth and incorporating parents in psychosocial interventions to optimize living with JIA.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the Shadow: Unraveling the Cause of Blindness.","authors":"Manush Sondhi,Iman Qaiser,Samina Hayat,Sarwat Umer,Kinza Muzaffar","doi":"10.1002/acr.25435","DOIUrl":"https://doi.org/10.1002/acr.25435","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"19 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low socioeconomic status and female sex are associated with worse functional status in axial spondyloarthritis.","authors":"Rachael Stovall, Jing Li, Jessica Fitzpatrick, Eric Roberts, Andriko Palmowski, Christine Anastasiou, Zara Izadi, Janna Friedly, Namrata Singh, Lianne S. Gensler, Gabriela Schmajuk, Jinoos Yazdany","doi":"10.1002/acr.25436","DOIUrl":"https://doi.org/10.1002/acr.25436","url":null,"abstract":"We determined whether socioeconomic status (SES) and sex are associated with functional status (FS) in axial spondyloarthritis (axSpA).","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"53 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142261996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Collaborative Care Better Care?","authors":"James T Rosenbaum, Nicole Fett, Daniela Ghetie, Julianna Desmarais","doi":"10.1002/acr.25434","DOIUrl":"10.1002/acr.25434","url":null,"abstract":"","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurable Outcomes of an Ophthalmology and Rheumatology Coordinated Care Clinic","authors":"Catherine Lavallee, Monica Ahrens, Stefanie Davidson, Haseeb Goheer, Allison Shuster, Melissa A. Lerman","doi":"10.1002/acr.25433","DOIUrl":"https://doi.org/10.1002/acr.25433","url":null,"abstract":"Evaluate the impact of an Ophthalmology/Rheumatology multidisciplinary clinic for patients with anterior uveitis by comparing outcomes between those who received traditional care (TC) versus coordinated care (CC).","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"34 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142262005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of sex, serostatus, and smoking on risk for rheumatoid arthritis‐associated interstitial lung disease subtypes","authors":"Gregory C McDermott, Keigo Hayashi, Pierre‐Antoine Juge, Ritu Gill, Suzanne Byrne, Staci Gagne, Xiaosong Wang, Misti L Paudel, Matthew Moll, Michael H Cho, Kathleen Vanni, Emily Kowalski, Grace Qian, Katarina Bade, Alene Saavedra, Yumeko Kawano, Michael DiIorio, Taylor Wolfgang, Edy Y Kim, Paul F Dellaripa, Michael E Weinblatt, Nancy Shadick, Tracy J Doyle, Jeffrey A Sparks","doi":"10.1002/acr.25432","DOIUrl":"https://doi.org/10.1002/acr.25432","url":null,"abstract":"ObjectivesRA‐associated interstitial lung disease (RA‐ILD) includes multiple subtypes with varying histopathology, prognosis, and potential treatments. Limited research has investigated risk factors for different RA‐ILD subtypes. Therefore, we examined demographic, serologic, and lifestyle associations with RA‐ILD subtypes.MethodsWe systematically identified RA‐ILD cases and RA‐noILD controls in the Brigham RA Sequential Study and Mass General Brigham Biobank RA cohort. We determined RA‐ILD subtype (usual interstitial pneumonia [UIP], nonspecific interstitial pneumonia [NSIP], and other/indeterminate) through chest high‐resolution computed tomography imaging pattern. We investigated associations between demographic, lifestyle, and serologic factors and major RA‐ILD subtypes using multivariable logistic regression.ResultsAmong 3328 RA patients, we identified 208 RA‐ILD cases and 547 RA‐noILD controls. RA‐UIP was associated with older age (OR 1.03 per year, 95%CI 1.01 to 1.05), male sex (OR 2.15, 95%CI 1.33 to 3.48), and seropositivity (OR 2.08 95%CI 1.24 to 3.48) while RA‐NSIP was significantly associated only with seropositive status (OR 3.21, 95%CI 1.36 to 7.56). Non‐fibrotic ILDs were significantly associated with smoking (OR 2.81, 95%CI 1.52 to 5.21). Having three RA‐ILD risk factors (male, seropositive, smoking) had an OR of 6.89 (96%CI 2.41 to 19.7) for RA‐UIP compared to having no RA‐ILD risk factors.ConclusionsOlder age, seropositivity, and male sex were strongly associated with RA‐UIP while RA‐related autoantibodies were associated with RA‐NSIP. These findings suggest RA‐ILD sex differences may be driven by RA‐UIP and emphasizes the importance of further studies to clarify RA‐ILD heterogeneity and optimize screening and treatment approaches.","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":"2019 1","pages":""},"PeriodicalIF":4.7,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142184398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Adaptive Choice-Based Conjoint Approach to Facilitate Shared Decision-Making in Osteoarthritis Management: A Patient Perception Study.","authors":"Basem Al-Omari, Joviana Farhat, Mohanad Odeh, Mumtaz Khan, Hristo Grancharov, Zaki Abu Zahr, Sammy Hanna, Abdulla Alrahoomi","doi":"10.1002/acr.25429","DOIUrl":"10.1002/acr.25429","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the application of the adaptive choice-based conjoint (ACBC) method to facilitate the shared decision-making (SDM) process for osteoarthritis (OA) treatment.</p><p><strong>Methods: </strong>The study recruited adult patients with OA attending the rheumatology/orthopedics clinics in a local urban hospital in Abu Dhabi, United Arab Emirates (UAE). Participants completed a questionnaire regarding who influences their decision in selecting OA medication, followed by an ACBC questionnaire about OA medication preferences and a questionnaire about the potential contribution of ACBC to the SDM process. A univariate analysis was used to investigate the relationships between participant variables and factors that influence their decision-making processes. The chi-squared test, Fisher's exact test, Cramér's V coefficient test, and multivariable logistic regression analysis were used. The primary outcome investigates the contribution of the ACBC method to the SDM process for OA treatment. Secondary outcomes measure the association between patient demographics and variables related to the SDM process and ACBC questionnaire.</p><p><strong>Results: </strong>Five hundred patients participated in this study, with a response rate of 100%. Most study participants were 60 to 69 years old (34.8%), women (78.8%), and UAE nationals (90.4%). Patients' opinions and online or paper information influencing their decision in selecting OA medication had a statistically significant association with age, gender, education, and employment (P = 0.001, P = 0.039, P = 0.002, and P = 0.001, respectively). Employment status showed the strongest association (φc 0.170) with being independent in making the decision about OA medications, whereas education levels showed the strongest association (φc 0.24) with decisions impacted by online or paper information. The results of the multivariable logistic analysis showed that the only statistically significant variable for online or paper information that influenced the decision in selecting OA medication was education level (P = 0.003). Most participants agreed or strongly agreed that the ACBC predicted their preferences for OA treatment (96.8%) and that the questionnaire may help doctors understand patient preferences (93%), and they recommended the use of the ACBC tool in doctors' clinics to aid the SDM process (92.8%) between patients and their physicians.</p><p><strong>Conclusion: </strong>An ACBC approach can facilitate doctors' understanding of patient preferences and aid the SDM process. Most patients with OA are independent or influenced by their physician when making decisions about OA medication. Higher education and employment among patients with OA are associated with a better involvement in the SDM process for available treatment.</p>","PeriodicalId":8406,"journal":{"name":"Arthritis Care & Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}