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Outcomes in rheumatoid arthritis: incorporating the patient perspective
Jenny E Heller1, Nancy A Shadick
1Division of Rheumatology, Immunology and Allergy, Brigham & Women's Hospital, Department of Medicine, Harvard Medical School, Boston, Massachusetts 02115, USA.
Purpose Of Review:
As biologics have improved the prognosis for rheumatoid arthritis, the prioritization of outcomes has shifted. Methods of quantifying concerns of particular importance to patients as a basis for better addressing the patient perspective in treatment are being developed. This review aims first to highlight some of the recent research in more traditional outcomes and then to focus on the rapid development of patient-centered outcomes over the last several years.
Recent Findings:
Clinical trials with combinations of biologics and other disease-modifying antirheumatic drugs have reported significant improvement in radiographs, inflammatory markers and joint exams in rheumatoid arthritis patients. Concomitantly, several studies have appeared in major journals, reporting that patients are emphasizing outcomes such as fatigue, return to normalcy and mental health that are less easily measured by the traditional outcomes markers.
Summary:
Recent studies have shown both that rheumatologist and patient approaches to achieving wellness differ and providing patients with a sense of control in reaching that state of wellness leads to better outcomes. Current research is focused on evaluating how best to measure the patient assessments and incorporate the patient voice into the clinic.
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Patient outcomes reflect the patient's response to the goal rather than what the nurse aims to achieve. Terminology should be observable and measurable to avoid the reader's interpretation. The desired outcome should be realistic and achievable in the designated care timeframe. Expected outcomes should align with adjunctive therapies. The outcome should enhance care evaluation by...
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