{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T18:40:59Z","timestamp":1791052859782,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis Care &amp;amp; Research"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore patient priorities and ranking of factors influencing patient decision\u2010making concerning treatment escalation in the management of Raynaud\u2019s phenomenon (RP) secondary to systemic sclerosis (SSc).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with SSc were invited to participate in an online survey disseminated through patient\u2010led organizations and social media platforms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses from 747 individuals with self\u2010reported SSc\u2010RP were evaluable with broad international representation. The mean \u00b1 SD age (54.7 \u00b1 12.1 years), clinical phenotype, and disease subsets distribution (limited cutaneous SSc [402 of 747, 53.8%], diffuse cutaneous SSc [260 of 747, 34.8%], and overlap disease [85 of 747, 11.4%]) were consistent with expected demographic information. Around one\u2010half (56.3%) of patients reported that their SSc\u2010RP symptoms were adequately controlled. The 5 highest ranked factors (of 13) that would prompt treatment escalation for SSc\u2010RP were as follows: 1) inability to use the fingers properly; 2) emergence of new digital ulcer on \u22651 fingers; 3) worsening pain or discomfort from RP; 4) more severe attacks; and 5) if it may help with internal problems. Despite symptoms not being adequately controlled, 47.1% were concerned about potential treatment side effects and were more likely to accept mild (~20\u201340%) versus severe (2%) side effects. Patients were open to different management strategies for uncontrolled RP that included adding new treatment in combination with existing treatment (52.8%), drug substitution (40.9%), increasing the current dose (28.8%), or focusing on nonpharmacologic approaches (29.7%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We have identified the relative importance of different factors influencing patient preferences for treatment decision\u2010making regarding SSc\u2010RP. Side\u2010effect profiles influence acceptability of drug treatments, and many patients report a preference for nonpharmacologic management of SSc\u2010RP.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acr.24710","type":"journal-article","created":{"date-parts":[[2021,5,31]],"date-time":"2021-05-31T07:56:10Z","timestamp":1622447770000},"page":"1845-1852","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Factors Influencing Patient Decision\u2010Making Concerning Treatment Escalation in Raynaud\u2019s Phenomenon Secondary to Systemic Sclerosis"],"prefix":"10.1002","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3361-4909","authenticated-orcid":false,"given":"Michael","family":"Hughes","sequence":"first","affiliation":[{"name":"Royal Hallamshire Hospital Sheffield Teaching Hospitals NHS Foundation Trust Sheffield 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