San Francisco General Hospital|University of California, San Francisco
objective treattotarget guidelines promote shared decision making sdm rheumatoid arthritis ra also high cost potential toxicity therapies sdm central patient safety objective examine patterns perceived communication around decision making 2 cohorts adults ra methods data derived patients enrolled 1 2 longitudinal observational cohorts university california san francisco ucsf ra cohort ra panel cohort subjects completed telephone interview preferred language included measure patientprovider communication including items decision making measures trust physician education language proficiency also asked logistic regression performed identify correlates suboptimal sdm communication analyses performed sample separately results 509 patients across 2 cohorts 30 32 reported suboptimal sdm communication low trust physician independently associated suboptimal sdm communication cohorts older age limited english proficiency independently associated suboptimal sdm ucsf ra cohort limited health literacy ra panel cohort conclusion study 500 adults ra 2 demographically distinct cohorts found nearly onethird subjects report suboptimal sdm communication clinicians regardless cohort lower trust physician independently associated suboptimal sdm communication cohorts limited english language proficiency older age ucsf ra cohort limited health literacy ra panel cohort findings underscore need examine influence sdm health outcomes ra