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Alves Pereira I, Maldonado Cocco J, Feijó Azevedo V, Guerra G, Bautista-Molano W, Casasola JC, Vega Morales D, Soriano ER, Gil DR, Zazzetti F, Aldunate L, Holdsworth EA, Massey O, Lobosco S, Lawson F. Levels of satisfaction with rheumatoid arthritis treatment and associated alignment between physicians and patients across Latin America. Clin Rheumatol 2020; 39:1813-1822. [PMID: 32030635 DOI: 10.1007/s10067-019-04858-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/10/2019] [Accepted: 11/14/2019] [Indexed: 02/07/2023]
Abstract
INTRODUCTION 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). METHOD 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. RESULTS 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. CONCLUSIONS 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.Key Points• 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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Affiliation(s)
- Ivanio Alves Pereira
- Divisão de Reumatologia, Hospital Universitário, Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | - José Maldonado Cocco
- School of Medicine, Buenos Aires University and Argentine Rheumatologic Foundation Dr. Osvaldo Carcia Morteo, Buenos Aires, Argentina
| | | | - Generoso Guerra
- Internal Medicine and Rheumatology, Centro Médico Royal Center Paitilla, Panama City, Panamá
| | - Wilson Bautista-Molano
- Rheumatology Section, University Hospital Fundación Santa Fe de Bogotá and Universidad Militar Nueva Granada, Bogotá, Colombia
- School of Medicine, Universidad Militar Nueva Granada, Bogotá, Colombia
| | | | - David Vega Morales
- Rheumatology Service, Internal Medicine Department, Hospital Universitario "Dr. José Eleuterio González", Universidad Autónoma de Nuevo León, Monterrey, Mexico
| | - Enrique Roberto Soriano
- Sección Reumatología, Servicio de Clínica Médica, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Instituto Universitario Escuela de Medicina Hospital Italiano de Buenos Aires, Fundación Pedro M Catoggio para el progreso de la Reumatologia, Buenos Aires, Argentina
| | - Diana Rocío Gil
- Internal Medicine and Rheumatology, ART Medica-Hospital Universitario Mayor MEDERI, Bogota, Colombia
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Ciapponi A, Virgilio SA, Berrueta M, Soto NC, Ciganda Á, Rojas Illanes MF, Rubio Martinez B, Gamba J, González Salazar CA, Rocha Rodríguez JN, Scarpellini B, Bravo Perdomo AM, Machnicki G, Aldunate L, De Paula J, Bardach A. Epidemiology of inflammatory bowel disease in Mexico and Colombia: Analysis of health databases, mathematical modelling and a case-series study. PLoS One 2020; 15:e0228256. [PMID: 31986191 PMCID: PMC6984728 DOI: 10.1371/journal.pone.0228256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/12/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIMS Ulcerative Colitis (UC) and Crohn's Disease (CD) have a major impact on quality of life and medical costs. The aim of the study was to estimate the prevalence, incidence and clinical phenotypes of Inflammatory Bowel Disease (IBD) cases in Mexico and Colombia. METHODS We analyzed official administrative and health databases, used mathematical modelling to estimate the incidence and complete prevalence, and performed a case-series of IBD patients at a referral center both in Mexico and Colombia. RESULTS The age-adjusted complete prevalence of UC per 100,000 inhabitants for 2015/2016 ranged from 15.65 to 71.19 in Mexico and from 27.40 to 69.97 in Colombia depending on the model considered. The prevalence of CD per 100,000 inhabitants in Mexico ranged from 15.45 to 18.08 and from 16.75 to 18.43 in Colombia. In Mexico, the age-adjusted incidence of UC per 100,000 inhabitants per year ranged from 0.90 to 2.30, and from 0.55 to 2.33 in Colombia. The incidence for CD in Mexico ranged from 0.35 to 0.66 whereas in Colombia, the age-adjusted incidence of CD ranged from 0.30 to 0.57. The case-series included 200 IBD patients from Mexico and 204 patients from Colombia. The UC/CD prevalence ratio in Mexico and Colombia was 1.50:1 and 4.5:1 respectively. In Mexico, the female/male prevalence ratio for UC was 1.50:1 and 1.28:1 for CD, while in Colombia this ratio was 0.68:1 for UC and 0.8:1 for CD. In Mexico the relapse rate for UC was 63.3% and 72.5% for CD, while those rates in Colombia were 58.2% for UC and 58.3% for CD. CONCLUSIONS The estimated burden of disease of IBD in Mexico and Colombia is not negligible. Although these findings need to be confirmed by population-based studies, they are useful for decision-makers, practitioners and patients with this condition.
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Affiliation(s)
- Agustín Ciapponi
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | | | - Mabel Berrueta
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Natalie Claire Soto
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | - Álvaro Ciganda
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
| | | | | | - Johana Gamba
- Fundación Universitaria Sánitas, Bogotá, Colombia
| | | | | | | | | | | | | | - Juan De Paula
- Hospital Italiano de Buenos Aires (HIBA), Buenos Aires, Argentina
| | - Ariel Bardach
- Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina
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