{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:04:09Z","timestamp":1787166249213,"version":"build-2736575974"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T00:00:00Z","timestamp":1578355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100015661","name":"UCB Pharma","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100015661","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Arthritis Res Ther"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Few studies have investigated patients\u2019 own treatment goals in rheumatoid arthritis (RA). The objective of this real-world, cross-sectional study of US patients with RA was to identify factors that patients believed influenced their physician\u2019s treatment decisions. Secondary objectives included reasons patients tolerated sub-optimal disease control and their perceived barriers to treatment optimization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eligible participants were enrolled in the ArthritisPower registry, \u2265\u200919\u2009years, had physician-diagnosed RA, unchanged treatment within 3\u2009months of baseline, prior\/current disease-modifying antirheumatic drug treatment (DMARDs), and computer\/smartphone access. In December 2017, participants completed Patient-Reported Outcomes Measurement Information System-Computerized Adaptive Tests (PROMIS-CAT) for pain interference, fatigue, sleep disturbance, and physical function. Routine Assessment of Patient Index Data 3 (RAPID3) provided disease activity scores (0\u201330). Participants completed an online survey on barriers to treatment optimization, including self-perception of disease compared to RAPID3\/PROMIS scores.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 249 participants met inclusion criteria and completed the survey. Mean age (SD) was 52 (11) years, and the majority were female (92%) with high RAPID3 disease activity (175\/249 [70%]; median score 18). The main reason participants did not change treatment was their physician\u2019s recommendation (66%;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200932). Of participants with high RAPID3 disease activity, 66 (38%) were offered a treatment change; 19 (29%) of whom declined the change. Most participants who intensified treatment did so because their symptoms had remained severe or worsened (51%;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200933); only 16 (25%) participants intensified because they had not reached a specified treatment goal. Among participants who self-reported their disease activity as \u201cnone\/low\u201d or \u201cmedium\u201d (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009202; 81% of cohort), most still had RAPID3 high disease activity (137\/202 [68%]; score\u2009&gt;\u200912). Most PROMIS scores showed moderate agreement with participants\u2019 self-assessment of health status, in contrast to RAPID3 (weighted kappa: 0.05 [95% CI \u2212\u20090.01, 0.11]).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most participants trusted their rheumatologist\u2019s treatment decisions and prioritized their physician\u2019s treatment goals over their own. Patients should be encouraged to share their treatment goals\/expectations with their rheumatologist, in line with the treat-to-target approach. RAPID3 may be inappropriate for setting patient-centric treatment goals given the poor agreement with self-reported disease activity; most PROMIS scores showed better alignment with patients\u2019 own assessments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13075-019-2076-7","type":"journal-article","created":{"date-parts":[[2020,1,7]],"date-time":"2020-01-07T12:03:15Z","timestamp":1578398595000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Barriers to treatment optimization and achievement of patients\u2019 goals: perspectives from people living with rheumatoid arthritis enrolled in the ArthritisPower registry"],"prefix":"10.1186","volume":"22","author":[{"given":"Kelly","family":"Gavigan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Benjamin","family":"Nowell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mylene S.","family":"Serna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Stark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Yassine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey R.","family":"Curtis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,1,7]]},"reference":[{"key":"2076_CR1","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1002\/acr.22108","volume":"66","author":"K Tymms","year":"2014","unstructured":"Tymms K, Zochling J, Scott J, et al. Barriers to optimal disease control for rheumatoid arthritis patients with moderate and high disease activity. Arthritis Care Res. 2014;66:190\u20136.","journal-title":"Arthritis Care Res."},{"key":"2076_CR2","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1136\/annrheumdis-2015-207524","volume":"75","author":"JS Smolen","year":"2016","unstructured":"Smolen JS, Breedveld FC, Burmester GR, et al. Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. 2016;75:3\u201315.","journal-title":"Ann Rheum Dis"},{"key":"2076_CR3","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1002\/art.33380","volume":"64","author":"LR Harrold","year":"2012","unstructured":"Harrold LR, Harrington JT, Curtis JR, et al. Prescribing practices in a US cohort of rheumatoid arthritis patients before and after publication of the American College of Rheumatology treatment recommendations. 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The study was reviewed and deemed exempt by the Schulman Institutional Review Board (SAIRB; now Advarra).","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All the results presented in this article are in aggregate form, and no personally identifiable information was used for this study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"MSS, JLS, and MY are employees and stockholders of the UCB Pharma. JRC received grant\/research and consultancy fees from the AbbVie, Amgen-Roche, Bristol-Myers Squibb, Corrona, Crescendo, Genentech, Janssen, Pfizer, and UCB Pharma. All other authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4"}}