Discordance (misalignment) regarding treatment satisfaction may exist in real-life clinical practice between patients and their physicians. We aimed to assess physician and patient treatment satisfaction levels and associated degree of misalignment in rheumatoid arthritis (RA).
A point-in-time, multinational survey of patients and physicians was conducted in Latin America from December 2014 to October 2015. Physician- and patient-reported satisfaction levels with current RA treatment, alignment levels in satisfaction perception, and factors associated with satisfaction misalignment were assessed through bivariate and logistic regression analyses.
Participating physicians (N = 114) completed 555 patient record forms (PRFs); 372 patients completed self-complete questionnaires (PSC). A total of 346 physician-patient pairs were analyzed. Physicians reported satisfaction with current disease control in 270/346 (78.0%) PRFs; patients reported such satisfaction in 286/346 (82.7%) PSCs. Physician-patient alignment was observed in 78.6% of pairs. Compared with aligned patients, misaligned patients were younger, more likely to have moderate or severe disease (physician subjectively defined), deteriorating or unstable disease (physician subjectively defined), been exposed to a greater number of advanced therapy lines (biologic or Janus kinase inhibitor), greater current pain, a current acute episode, poorer health, and greater disability and impairment. Misaligned patients were less likely to be in remission. Logistic regression analysis revealed that misaligned patients were more likely to experience greater activity impairment.
High treatment satisfaction and alignment were observed among RA patients and their physicians in Latin America. Misaligned patients were more likely to report more severe disease and were less likely to be in remission. Addressing misalignment may lead to improved RA disease control.
• High treatment satisfaction was observed among RA patients and their treating physicians in Latin America.
• One-fifth of physician-patient pairs were misaligned in treatment satisfaction.
• Patients misaligned with their physicians reported higher disease activity, lower quality of life, and greater disability than those who were aligned with their physicians.
• Understanding and addressing misalignment in treatment satisfaction may improve outcomes in this patient population.
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The authors would like to thank all patients and physicians who took part in the survey. Derek Ho, PhD, provided medical writing support in the development of this manuscript. FZ, LA and FL are employees of Janssen, who sponsored this research.
EH, OM and SL are employees of Adelphi Real World who received funding from Janssen for this research. Other authors do not have a financial relationship with Janssen.
Conflict of interest
All authors have access to the primary data and agree the journal can review data if requested. FZ, LA and FL are employees of Janssen, who sponsored this research. EH, OM and SL are employees of Adelphi Real World who received funding from Janssen for this research. Other authors do not have a financial relationship with Janssen.
All participating patients provided informed consent for use of their anonymized and aggregated data for research and publication in scientific journals. Data collection was performed such that patients and physicians could not be identified directly, and all data were aggregated and de-identified before receipt. Data collection was performed in accordance with the European Pharmaceutical Marketing Research Association  guidelines; ethics committee approval was thus not required. Each survey was performed in full accordance with relevant legislation at the time of data collection, including the US Health Insurance Portability and Accountability Act 1996  and Health Information Technology for Economic and Clinical Health Act legislation .
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Alves Pereira, I., Maldonado Cocco, J., Feijó Azevedo, V. et al. Levels of satisfaction with rheumatoid arthritis treatment and associated alignment between physicians and patients across Latin America. Clin Rheumatol (2020). https://doi.org/10.1007/s10067-019-04858-x
- Biologic therapy
- Decision making
- Latin America
- Patient engagement
- Patient satisfaction
- Rheumatoid arthritis