Jennifer H. Lofland|P. Johnson|M. Ingham|Sarah Rosemas|John White|Lorie Ellis
Shared decision-making for biologic treatment of autoimmune disease: influence on adherence, persistence, satisfaction, and health care costs
Janssen (United States)|Optum (United States)|Janssen (United States)|Optum (United States)|Optum (United States)|Janssen (United States)
shared decisionmaking sdm process whereby physicians patients collaborate select interventions well understood biologic treatment autoimmune conditionsthis crosssectional survey adults initiating treatment crohns disease ulcerative colitis inflammatory bowel disease ibd psoriatic arthritis rheumatoid arthritis rapa survey data linked administrative claims 6 months baseline followup therapy initiation measures included shared decision making questionnaire patient activation measure pam morisky medication adherence scale mmas general health treatment satisfaction claimsbased quancharlson comorbidity scores persistence medication possession ratio mpr health care costs examined patients compared participation sdm nonparticipation nonsdm sdmamong 453 respondents 357 eligible 306 patients 204 rapa 102 ibd included analyses overall n357 sdm participants n120 often females 750 vs 625 p0018 lower health status 480 vs 554 p0005 higher quancharlson scores 10 vs 07 p0035 nonsdm n237 participants lower mmas scores sdm 017 vs nonsdm 041 p005 indicated greater likelihood adherence sdm participants also reported higher satisfaction medication greater activation pam sdm vs nonsdm 669 vs 616 p0001 mean mpr differ persistence longer among sdm participants 1112 days vs 1022 days nonsdm p0029 costs differ sdm status overall among patients rapa patients ibd however experienced lower p0003 total costs 9404 sdm vs 25071 nonsdm followupthis study showed greater likelihood adherence satisfaction patients engaged sdm reduced health care costs among patients ibd engaged sdm study provides basis defining sdm participation detecting differences sdm participation biologic treatment selection autoimmune conditions