Main Category: Arthritis / Rheumatology
Article Date: 29 May 2011 – 2:00 PDT
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While the majority of patients with Rheumatoid Arthritis (RA) feel that personalized goal setting would have a positive impact on disease management, many stated that their health care professionals (HCPS) are not discussing approaches to achieving personal or social goals, reports a survey presented at the Annual Meeting of the European League Against Rheumatism (EULAR) in London, May 25-28.
The “Getting to your destination faster” survey was conducted to examine patients’ expectations of treatment and outcomes in RA, with a particular focus on goal setting practices. The internet survey was completed by 1,829 responders, aged 25 to 65 years, from UK, Germany, Spain, France, Italy and US. Results showed:
- That 87% of respondents agreed that establishing personal targets and achieving them would have a positive impact on their disease management.
- 73% stated that their HCPs did not discuss approaches that achieved personal targets.
- 62% agreed that decisions about how to treat their RA were generally shared between the HCP and themselves.
- 60% of responders had not heard of the treat to target approach.
“The survey highlights that RA patients want to be proactively involved in the management of their condition and set what they see as realistic goals for improving quality of life. The results are a clarion call to HCPs to wake up and take note of this,” said Professor Peter Taylor, lead author of the study, from the Kennedy Institute of Rheumatology, London, adding that the best treatment outcomes arise when patients and HCPs work together in partnership.
The type of goals mentioned by responders to the survey included feeling less tired so that they could do activities with their children, being able to sleep through the night without waking in pain, being able to open every day items such as jars, and being able to use their computer without pain.
The preferred EULAR guideline target is remission as assessed by a DAS28 less than or equal to 2.6. Where that is not possible a target of low disease activity is recommended as assessed by a DAS28 less than or equal to 3.2.
Appropriate personal and social goal setting, added Taylor, is particularly important for the large numbers of RA patients who fail to meet remission targets outlined by EULAR guidelines (remission defined as a DAS28 score below 2.6, low disease activity as a score less or equal to 3.2).
“The reality for many patients (particularly those who’ve had RA for several years prior to anti TNF treatments) is that EULAR targets are not achievable, which can be demoralizing. Helping patients to achieve personal targets is a way of showing them they’re doing well in keeping their disease under control.”
P Taylor, V Strand, T Sensky, et al. Patient Expectations of Treatment Goals and Goal-Setting Practices in Rheumatoid Arthritis. EULAR. FRI0256
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