Knowledge, Trust Improve Shared Decision-Making for PsA Medication

Improving knowledge and trust with rheumatologists in supportive, collaborative environments could enhance shared decision-making with patients regarding medications for psoriatic arthritis (PsA), suggests a study published online ahead of print in Arthritis Care & Research. 

“Patients with psoriatic arthritis lack agency in making treatment decisions,” researchers reported, “and are overwhelmed by the potential harms of systemic medication.”

The finding stems from semistructured, in-person interviews with 25 adults with PsA in Australia. Researchers aimed to describe the perspectives of patients with PsA around shared decision-making on medication taking.

The study identified 5 themes that emerged during interviews. First, patients expressed a lack of agency in decision-making due to a lack of choice or knowledge, unfair eligibility restrictions, and desperation. Second, they felt overwhelmed by the potential harms of medication, such as jeopardizing fertility or lifestyle disruptions from side effects, and sought strategies for managing them.

A third theme that emerged was gaining confidence and empowerment through a growth in knowledge over time, which led to discernable benefits in function and mental health, according to the study. Fourth, patients opted for alternatives that would offer comprehensive solutions and ease suspicions of overmedication.

Finally, patients talked about developing trust and strengthening collaboration with clinicians through personable approaches, respectful negotiation, and consistency.

—Jolynn Tumolo

Reference

Sumpton D, Oliffe M, Kane B, et al. Patients’ perspectives on shared decision-making about medications in psoriatic arthritis: an interview study. Arthritis Care Res. Published online ahead of print July 7, 2021.