{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,11]],"date-time":"2025-09-11T17:23:26Z","timestamp":1757611406200,"version":"3.44.0"},"reference-count":30,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2023,5,15]]},"published-print":{"date-parts":[[2023,6]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To develop a web-based evidence-based decision aid to support shared decision-making in patients with axial spondyloarthritis (axSpA) who face a treatment decision to initiate or switch a biological or targeted synthetic disease modifying antirheumatic drug (b\/tsDMARDs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Through an iterative process, we systematically developed a decision aid based on evidence from the literature, explorative needs assessment interviews among patients and care providers, and input from experts of the SpA working group of the Dutch Society for Rheumatology and professionals on patient information employed at the Dutch Arthritis Society. The usability, ease of use and feasibility of the pilot version were tested among stakeholders and feedback was used to adapt the decision aid. Finally, a multifaceted strategy was used to introduce the decision aid in clinical practice.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The decision aid consists of (1) consultation support instructions in the context of disease control and treatment needs, (2) an overview of available treatment options for axSpA, (3) detailed information on b\/tsDMARDs and an interactive option grid that facilitates comparison of characteristics and (4) a final check supporting patients to deliberate on the decision to initiate or switch a b\/tsDMARD. Rheumatologists introduced the decision aid in several Dutch rheumatology settings and the Dutch Arthritis Society posted it on their website, social media and in their monthly newsletter.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>We developed an evidence-based decision aid to support axSpA patients who face a treatment decision to initiate or switch a b\/tsDMARD and introduced this in clinical practice.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/rmdopen-2023-003103","type":"journal-article","created":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T10:38:38Z","timestamp":1685615918000},"page":"e003103","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Development of a web-based decision aid for initiating biological or targeted synthetic disease-modifying antirheumatic drugs (b\/tsDMARDs) in axial spondyloarthritis"],"prefix":"10.1136","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1098-8908","authenticated-orcid":false,"given":"Esther","family":"Beckers","sequence":"first","affiliation":[{"name":"Department op Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0682-9533","authenticated-orcid":false,"given":"Annelies","family":"Boonen","sequence":"additional","affiliation":[{"name":"Department op Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8477-0683","authenticated-orcid":false,"given":"Astrid","family":"van Tubergen","sequence":"additional","affiliation":[{"name":"Department op Internal Medicine, Division of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands"},{"name":"Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,6,1]]},"reference":[{"key":"2025090312504323000_9.2.e003103.1","unstructured":"Institute of Medicine Committee on Quality of Health Care in America . Crossing the quality chasm: a new health system for the 21st century. Washington DC, United States of America: National Academies Press, 2001."},{"key":"2025090312504323000_9.2.e003103.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.10186"},{"key":"2025090312504323000_9.2.e003103.3","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-012-2077-6"},{"key":"2025090312504323000_9.2.e003103.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38926.629329.AE"},{"key":"2025090312504323000_9.2.e003103.5","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X13501721"},{"key":"2025090312504323000_9.2.e003103.6","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1136\/ebm.6.4.100","article-title":"Using patient decision aids to promote evidence-based decision making","volume":"6","author":"O\u2019connor","year":"2001","journal-title":"Evid Based Med"},{"key":"2025090312504323000_9.2.e003103.7","article-title":"Decision AIDS for people facing health treatment or screening decisions","volume":"4","author":"Stacey","year":"2017","journal-title":"Cochrane Database Syst Rev"},{"key":"2025090312504323000_9.2.e003103.8","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223296"},{"key":"2025090312504323000_9.2.e003103.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31591-4"},{"key":"2025090312504323000_9.2.e003103.10","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2474-15-333","article-title":"Patient participation in decisions about disease modifying anti-rheumatic drugs: a cross-sectional survey","volume":"15","author":"Nota","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"2025090312504323000_9.2.e003103.11","doi-asserted-by":"crossref","first-page":"1225","DOI":"10.1007\/s10067-014-2820-y","article-title":"Arthritis patients' motives for (not) wanting to be involved in medical decision-making and the factors that hinder or promote patient involvement","volume":"35","author":"Nota","year":"2016","journal-title":"Clin Rheumatol"},{"key":"2025090312504323000_9.2.e003103.12","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.2147\/PPA.S204111","article-title":"Preferences of patients with rheumatoid arthritis regarding disease-modifying antirheumatic drugs: a discrete choice experiment","volume":"13","author":"van Heuckelum","year":"2019","journal-title":"Patient Prefer Adherence"},{"key":"2025090312504323000_9.2.e003103.13","doi-asserted-by":"crossref","DOI":"10.1186\/s12911-017-0433-5","article-title":"Development of a web-based patient decision aid for initiating disease modifying anti-rheumatic drugs using user-centred design methods","volume":"17","author":"Nota","year":"2017","journal-title":"BMC Med Inform Decis Mak"},{"key":"2025090312504323000_9.2.e003103.14","unstructured":"Zorginstituut Nederland . Leidraad voor ontwikkelen van pati\u00ebnteninformatie en keuzehulpen bij kwaliteitsstandaarden in de curatieve zorg [Guideline for developing patient information and decision aids based on quality standards in curative care]. Diemen, The Netherlands: Zorginstituut Nederland, 2016."},{"key":"2025090312504323000_9.2.e003103.15","doi-asserted-by":"crossref","DOI":"10.1186\/1472-6947-13-S2-S2","article-title":"A systematic development process for patient decision AIDS","volume":"13 Suppl 2","author":"Coulter","year":"2013","journal-title":"BMC Med Inform Decis Mak"},{"key":"2025090312504323000_9.2.e003103.16","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2017-006986"},{"key":"2025090312504323000_9.2.e003103.17","doi-asserted-by":"crossref","DOI":"10.1186\/s12874-018-0594-7","article-title":"Characterising and justifying sample size sufficiency in interview-based studies: systematic analysis of qualitative health research over a 15-year period","volume":"18","author":"Vasileiou","year":"2018","journal-title":"BMC Med Res Methodol"},{"key":"2025090312504323000_9.2.e003103.18","unstructured":"Dutch Society for Rheumatology . Richtlijn doelmatig gebruik van biologicals bij reumato\u00efde artritis, axiale spondyloartritis en artritis psoriatica - 2014 Update Nederlandse vereniging voor reumatologie [Guideline on effective use of biologicals in rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis - 2014 Update Dutch Society for Rheumatology. Amsterdam, The Netherlands: Dutch Society for Rheumatology, 2014."},{"key":"2025090312504323000_9.2.e003103.19","unstructured":"Dutch Society for Rheumatology . Richtlijn verantwoord gebruik biologicals [Guideline responsible use of biologicals]. Utrecht, The Netherlands: Dutch Society for Rheumatology, 2018. Available: https:\/\/www.nvr.nl\/wp-content\/uploads\/2018\/09\/NVR-Medicijnen-richtlijn-verantwoord-gebruik-van-biologicals-januari-2011.pdf"},{"key":"2025090312504323000_9.2.e003103.20","unstructured":"Zorginstituut Nederland . Farmacotherapeutisch Kompas [Dutch pharmacotherapeutic database]. Diemen, The Netherlands: Zorginstituut Nederland, 2022. Available: https:\/\/www.farmacotherapeutischkompas.nl\/"},{"key":"2025090312504323000_9.2.e003103.21","unstructured":"European Medicines Agency . Human medicine European public assessment reports. Amsterdam, The Netherlands: European Medicines Agency, 2022. Available: https:\/\/www.ema.europa.eu\/en\/medicines\/ema_group_types\/ema_medicine"},{"key":"2025090312504323000_9.2.e003103.22","unstructured":"Dutch Arthritis Society . Keuzehulp behandeling reumato\u00efde artritis met medicijnen [Decision aid treatment rheumatoid arthritis with medicine]. Amsterdam, The Netherlands: Dutch Arthritis Society, 2021. Available: https:\/\/reumanederland.nl\/reuma\/behandelingen\/keuzehulp-behandeling-reumatoide-artritis\/"},{"key":"2025090312504323000_9.2.e003103.23","unstructured":"Stichting Lezen en Schrijven . Feiten & Cijfers Laaggeletterdheid- De invloed van lage basisvaardigheden op deelname aan de maatschappij [Facts & Figures Low literacy- The impact of low basic skills on participation in society]. The Hague, The Netherlands: Stichting Lezen en Schrijven, 2018."},{"key":"2025090312504323000_9.2.e003103.24","unstructured":"Pharos . Factsheet Laaggeletterdheid en beperkte gezondheidsvaardigheden [Fact sheet Low literacy and limited health skills]. Utrecht, The Netherlands, 2020. Available: https:\/\/www.pharos.nl\/factsheets\/laaggeletterdheid-en-beperkte-gezondheidsvaardigheden\/"},{"key":"2025090312504323000_9.2.e003103.25","unstructured":"Algemene Rekenkamer . Aanpak van laaggeletterdheid [Dealing with low literacy]. The Hague, The Netherlands: Algemene Rekenkamer, 2016."},{"key":"2025090312504323000_9.2.e003103.26","doi-asserted-by":"publisher","DOI":"10.2307\/249008"},{"key":"2025090312504323000_9.2.e003103.27","doi-asserted-by":"publisher","DOI":"10.5195\/ijt.2016.6196"},{"key":"2025090312504323000_9.2.e003103.28","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0004705","article-title":"Assessing the quality of decision support technologies using the International patient decision aid standards instrument (IPDASI)","volume":"4","author":"Elwyn","year":"2009","journal-title":"PLoS One"},{"key":"2025090312504323000_9.2.e003103.29","doi-asserted-by":"crossref","first-page":"151988","DOI":"10.1016\/j.semarthrit.2022.151988","article-title":"Factors influencing clinician prescribing of disease-modifying anti-rheumatic drugs for inflammatory arthritis: a systematic review and thematic synthesis of qualitative studies","volume":"55","author":"Lalor","year":"2022","journal-title":"Semin Arthritis Rheum"},{"key":"2025090312504323000_9.2.e003103.30","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.berh.2015.09.007","article-title":"Patient-centred care in established rheumatoid arthritis","volume":"29","author":"Voshaar","year":"2015","journal-title":"Best Pract Res Clin Rheumatol"}],"container-title":["RMD Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/rmdopen-2023-003103","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T19:50:53Z","timestamp":1756929053000},"score":1,"resource":{"primary":{"URL":"https:\/\/rmdopen.bmj.com\/lookup\/doi\/10.1136\/rmdopen-2023-003103"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,6,1]]},"published-print":{"date-parts":[[2023,6]]}},"alternative-id":["10.1136\/rmdopen-2023-003103"],"URL":"https:\/\/doi.org\/10.1136\/rmdopen-2023-003103","relation":{},"ISSN":["2056-5933"],"issn-type":[{"type":"electronic","value":"2056-5933"}],"subject":[],"published":{"date-parts":[[2023,6]]}}}