Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug
The causes of the underutilization of disease modifying anti-rheumatic drugs (DMARDS) for rheumatoid arthritis (RA) are not fully known, but may in part, relate to individual patient factors including risk perception. Our objective was to identify the determinants of risk perception (RP) in RA patie...
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| Veröffentlicht in: | BMC medical informatics and decision making 2013-08, Vol.13 (1), p.89-89, Article 89 |
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| creator | Martin, Richard W McCallops, Kelsey Head, Andrew J Eggebeen, Aaron T Birmingham, James D Tellinghuisen, Donald J |
| description | The causes of the underutilization of disease modifying anti-rheumatic drugs (DMARDS) for rheumatoid arthritis (RA) are not fully known, but may in part, relate to individual patient factors including risk perception. Our objective was to identify the determinants of risk perception (RP) in RA patients and predictors of their willingness to take a proposed DMARD (DMARD willingness).
A cross-sectional mail survey of RA patients in a community rheumatology practice. Patients were presented a hypothetical decision scenario where they were asked to consider switching DMARDs. They evaluated how risky the proposed medication was and how likely they would be to take it.
The completed sample included 1009 RA patients. The overall survey response rate was 71%.
age 61.6 years (range 18-93), 75% female, minority 6.5%, low or marginal health literacy 8.8%, depression 15.0%, duration RA 13.1 years (range 0.5 - 68). Regression models demonstrated that health literacy, independent of low educational achievement or other demographic (including race), was a common predictor of both RP and DMARD willingness. There was partial mediation of the effects of HL on DMARD willingness through RP. Depression and happiness had no significant effect on RP or DMARD willingness. RP was influenced by negative RA disease and treatment experience, while DMARD willingness was affected mainly by perceived disease control.
Risk aversion may be the result of potentially recognizable and correctable cognitive defect. Heightened clinician awareness, formal screening for low health literacy or cognitive impairment in high-risk populations, may identify patients could benefit from additional decision support. |
| doi_str_mv | 10.1186/1472-6947-13-89 |
| format | Article |
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A cross-sectional mail survey of RA patients in a community rheumatology practice. Patients were presented a hypothetical decision scenario where they were asked to consider switching DMARDs. They evaluated how risky the proposed medication was and how likely they would be to take it.
The completed sample included 1009 RA patients. The overall survey response rate was 71%.
age 61.6 years (range 18-93), 75% female, minority 6.5%, low or marginal health literacy 8.8%, depression 15.0%, duration RA 13.1 years (range 0.5 - 68). Regression models demonstrated that health literacy, independent of low educational achievement or other demographic (including race), was a common predictor of both RP and DMARD willingness. There was partial mediation of the effects of HL on DMARD willingness through RP. Depression and happiness had no significant effect on RP or DMARD willingness. RP was influenced by negative RA disease and treatment experience, while DMARD willingness was affected mainly by perceived disease control.
Risk aversion may be the result of potentially recognizable and correctable cognitive defect. Heightened clinician awareness, formal screening for low health literacy or cognitive impairment in high-risk populations, may identify patients could benefit from additional decision support.</description><identifier>ISSN: 1472-6947</identifier><identifier>EISSN: 1472-6947</identifier><identifier>DOI: 10.1186/1472-6947-13-89</identifier><identifier>PMID: 23938059</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Academic achievement ; Adolescent ; Adult ; Age ; Aged ; Aged, 80 and over ; Analysis ; Antirheumatic agents ; Antirheumatic Agents - therapeutic use ; Arthritis ; Arthritis, Rheumatoid - classification ; Arthritis, Rheumatoid - drug therapy ; Bias ; Cognitive ability ; Cross-Sectional Studies ; Decision Making ; Demographics ; Depression - epidemiology ; Depression, Mental ; Drug therapy ; Female ; Health aspects ; Health education ; Humans ; Insurance, Health ; Likert scale ; Low income groups ; Male ; Managed Care Programs - statistics & numerical data ; Mediation ; Medicaid ; Medical screening ; Michigan ; Middle Aged ; Patient Acceptance of Health Care - ethnology ; Patient Acceptance of Health Care - psychology ; Patient Acceptance of Health Care - statistics & numerical data ; Questionnaires ; Rheumatic diseases ; Rheumatoid factor ; Rheumatology ; Risk Factors ; Sex Distribution ; Studies ; Surveys and Questionnaires ; United States ; Young Adult</subject><ispartof>BMC medical informatics and decision making, 2013-08, Vol.13 (1), p.89-89, Article 89</ispartof><rights>COPYRIGHT 2013 BioMed Central Ltd.</rights><rights>2013 Martin et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</rights><rights>Copyright © 2013 Martin et al.; licensee BioMed Central Ltd. 2013 Martin et al.; licensee BioMed Central Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b580t-122f305023063fefa21a4733123cfe430a30938ca56d584a501bf2642e87bbc63</citedby><cites>FETCH-LOGICAL-b580t-122f305023063fefa21a4733123cfe430a30938ca56d584a501bf2642e87bbc63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751053/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751053/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,27922,27923,53789,53791</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23938059$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martin, Richard W</creatorcontrib><creatorcontrib>McCallops, Kelsey</creatorcontrib><creatorcontrib>Head, Andrew J</creatorcontrib><creatorcontrib>Eggebeen, Aaron T</creatorcontrib><creatorcontrib>Birmingham, James D</creatorcontrib><creatorcontrib>Tellinghuisen, Donald J</creatorcontrib><title>Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug</title><title>BMC medical informatics and decision making</title><addtitle>BMC Med Inform Decis Mak</addtitle><description>The causes of the underutilization of disease modifying anti-rheumatic drugs (DMARDS) for rheumatoid arthritis (RA) are not fully known, but may in part, relate to individual patient factors including risk perception. Our objective was to identify the determinants of risk perception (RP) in RA patients and predictors of their willingness to take a proposed DMARD (DMARD willingness).
A cross-sectional mail survey of RA patients in a community rheumatology practice. Patients were presented a hypothetical decision scenario where they were asked to consider switching DMARDs. They evaluated how risky the proposed medication was and how likely they would be to take it.
The completed sample included 1009 RA patients. The overall survey response rate was 71%.
age 61.6 years (range 18-93), 75% female, minority 6.5%, low or marginal health literacy 8.8%, depression 15.0%, duration RA 13.1 years (range 0.5 - 68). Regression models demonstrated that health literacy, independent of low educational achievement or other demographic (including race), was a common predictor of both RP and DMARD willingness. There was partial mediation of the effects of HL on DMARD willingness through RP. Depression and happiness had no significant effect on RP or DMARD willingness. RP was influenced by negative RA disease and treatment experience, while DMARD willingness was affected mainly by perceived disease control.
Risk aversion may be the result of potentially recognizable and correctable cognitive defect. Heightened clinician awareness, formal screening for low health literacy or cognitive impairment in high-risk populations, may identify patients could benefit from additional decision support.</description><subject>Academic achievement</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Antirheumatic agents</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis</subject><subject>Arthritis, Rheumatoid - classification</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Bias</subject><subject>Cognitive ability</subject><subject>Cross-Sectional Studies</subject><subject>Decision Making</subject><subject>Demographics</subject><subject>Depression - epidemiology</subject><subject>Depression, Mental</subject><subject>Drug therapy</subject><subject>Female</subject><subject>Health aspects</subject><subject>Health education</subject><subject>Humans</subject><subject>Insurance, Health</subject><subject>Likert scale</subject><subject>Low income groups</subject><subject>Male</subject><subject>Managed Care Programs - statistics & numerical data</subject><subject>Mediation</subject><subject>Medicaid</subject><subject>Medical screening</subject><subject>Michigan</subject><subject>Middle Aged</subject><subject>Patient Acceptance of Health Care - ethnology</subject><subject>Patient Acceptance of Health Care - psychology</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Questionnaires</subject><subject>Rheumatic diseases</subject><subject>Rheumatoid factor</subject><subject>Rheumatology</subject><subject>Risk Factors</subject><subject>Sex Distribution</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>United States</subject><subject>Young Adult</subject><issn>1472-6947</issn><issn>1472-6947</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNqFkk1v1DAQhiMEoqVw5oYsceGS1vbEiXNBKhUflSpxgbPlOONdt4kd7KSIf4_DlqWLipAPtmaeeTXzeoriJaOnjMn6jFUNL-u2akoGpWwfFcf7yON776PiWUrXlLJGgnhaHHFoQVLRHhf-0tthQW-QBEsmPTv0MzFbHbWZMbo0O5NI8GTCaNDdYk9y8CYR7Xvy3Q2D8xuPKZE5kFnfINFkimEKKYPaz66MW1zGLGtIH5fN8-KJ1UPCF3f3SfH1w_svF5_Kq88fLy_Or8pOSDqXjHMLVFAOtAaLVnOmqwaAcTAWK6AaaJ7AaFH3QlZaUNZZXlccZdN1poaT4u1Od1q6EXuTh4p6UFN0o44_VNBOHWa826pNuFXQCEYFZIF3O4HOhX8IHGZMGNXqt1r9VgyUbLPIm7suYvi2YJrV6JLBYdAew5IyDxXlLctj_R_lNc0_1oqMvv4LvQ5L9NnOX1TFJG3oH2qjB1TO25DbNKuoOhdQ1dDUbB3z9AEqnx5HZ4JH63L8oOBsV2BiSCmi3VvCqFpX8gETXt3_ij3_ewfhJwM-26g</recordid><startdate>20130812</startdate><enddate>20130812</enddate><creator>Martin, Richard W</creator><creator>McCallops, Kelsey</creator><creator>Head, Andrew J</creator><creator>Eggebeen, Aaron T</creator><creator>Birmingham, James D</creator><creator>Tellinghuisen, Donald J</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7SC</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AL</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>JQ2</scope><scope>K7-</scope><scope>K9.</scope><scope>L7M</scope><scope>LK8</scope><scope>L~C</scope><scope>L~D</scope><scope>M0N</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20130812</creationdate><title>Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug</title><author>Martin, Richard W ; McCallops, Kelsey ; Head, Andrew J ; Eggebeen, Aaron T ; Birmingham, James D ; Tellinghuisen, Donald J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b580t-122f305023063fefa21a4733123cfe430a30938ca56d584a501bf2642e87bbc63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Academic achievement</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Antirheumatic agents</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis</topic><topic>Arthritis, Rheumatoid - classification</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Bias</topic><topic>Cognitive ability</topic><topic>Cross-Sectional Studies</topic><topic>Decision Making</topic><topic>Demographics</topic><topic>Depression - epidemiology</topic><topic>Depression, Mental</topic><topic>Drug therapy</topic><topic>Female</topic><topic>Health aspects</topic><topic>Health education</topic><topic>Humans</topic><topic>Insurance, Health</topic><topic>Likert scale</topic><topic>Low income groups</topic><topic>Male</topic><topic>Managed Care Programs - statistics & numerical data</topic><topic>Mediation</topic><topic>Medicaid</topic><topic>Medical screening</topic><topic>Michigan</topic><topic>Middle Aged</topic><topic>Patient Acceptance of Health Care - ethnology</topic><topic>Patient Acceptance of Health Care - psychology</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Questionnaires</topic><topic>Rheumatic diseases</topic><topic>Rheumatoid factor</topic><topic>Rheumatology</topic><topic>Risk Factors</topic><topic>Sex Distribution</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>United States</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Martin, Richard W</creatorcontrib><creatorcontrib>McCallops, Kelsey</creatorcontrib><creatorcontrib>Head, Andrew J</creatorcontrib><creatorcontrib>Eggebeen, Aaron T</creatorcontrib><creatorcontrib>Birmingham, James D</creatorcontrib><creatorcontrib>Tellinghuisen, Donald J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Computer and Information Systems Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Computing Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Computer Science Collection</collection><collection>Computer Science Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>ProQuest Biological Science Collection</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>Computing Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMC medical informatics and decision making</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Martin, Richard W</au><au>McCallops, Kelsey</au><au>Head, Andrew J</au><au>Eggebeen, Aaron T</au><au>Birmingham, James D</au><au>Tellinghuisen, Donald J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug</atitle><jtitle>BMC medical informatics and decision making</jtitle><addtitle>BMC Med Inform Decis Mak</addtitle><date>2013-08-12</date><risdate>2013</risdate><volume>13</volume><issue>1</issue><spage>89</spage><epage>89</epage><pages>89-89</pages><artnum>89</artnum><issn>1472-6947</issn><eissn>1472-6947</eissn><abstract>The causes of the underutilization of disease modifying anti-rheumatic drugs (DMARDS) for rheumatoid arthritis (RA) are not fully known, but may in part, relate to individual patient factors including risk perception. Our objective was to identify the determinants of risk perception (RP) in RA patients and predictors of their willingness to take a proposed DMARD (DMARD willingness).
A cross-sectional mail survey of RA patients in a community rheumatology practice. Patients were presented a hypothetical decision scenario where they were asked to consider switching DMARDs. They evaluated how risky the proposed medication was and how likely they would be to take it.
The completed sample included 1009 RA patients. The overall survey response rate was 71%.
age 61.6 years (range 18-93), 75% female, minority 6.5%, low or marginal health literacy 8.8%, depression 15.0%, duration RA 13.1 years (range 0.5 - 68). Regression models demonstrated that health literacy, independent of low educational achievement or other demographic (including race), was a common predictor of both RP and DMARD willingness. There was partial mediation of the effects of HL on DMARD willingness through RP. Depression and happiness had no significant effect on RP or DMARD willingness. RP was influenced by negative RA disease and treatment experience, while DMARD willingness was affected mainly by perceived disease control.
Risk aversion may be the result of potentially recognizable and correctable cognitive defect. Heightened clinician awareness, formal screening for low health literacy or cognitive impairment in high-risk populations, may identify patients could benefit from additional decision support.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>23938059</pmid><doi>10.1186/1472-6947-13-89</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; PubMed Central Open Access; Springer Nature OA Free Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; SpringerLink Journals - AutoHoldings |
| subjects | Academic achievement Adolescent Adult Age Aged Aged, 80 and over Analysis Antirheumatic agents Antirheumatic Agents - therapeutic use Arthritis Arthritis, Rheumatoid - classification Arthritis, Rheumatoid - drug therapy Bias Cognitive ability Cross-Sectional Studies Decision Making Demographics Depression - epidemiology Depression, Mental Drug therapy Female Health aspects Health education Humans Insurance, Health Likert scale Low income groups Male Managed Care Programs - statistics & numerical data Mediation Medicaid Medical screening Michigan Middle Aged Patient Acceptance of Health Care - ethnology Patient Acceptance of Health Care - psychology Patient Acceptance of Health Care - statistics & numerical data Questionnaires Rheumatic diseases Rheumatoid factor Rheumatology Risk Factors Sex Distribution Studies Surveys and Questionnaires United States Young Adult |
| title | Influence of patient characteristics on perceived risks and willingness to take a proposed anti-rheumatic drug |
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