Implementing Treat-to-Target Practices for Chronic Pain Through Shared Decision Making: Requisites, Prospects, and...

Area of Science:

• Rheumatology
• Clinical Psychology
• Pain Management

Background:

• Treat-to-target (T2T) is a collaborative approach for managing chronic pain, involving goal setting, symptom assessment, and treatment adjustment.
• Patient participation in T2T has been questioned, but empirical evidence is lacking.
• Understanding factors influencing patient willingness to modify treatment is crucial for effective T2T implementation.

Purpose of the Study:

• To investigate the impact of patient-assessed disease activity (DA) and illness beliefs on their willingness to alter current treatments.
• To empirically assess patient capacity for collaborative decision-making in chronic pain management.

Main Methods:

• 157 rheumatoid arthritis patients completed assessments of disease activity (pain, function) and illness beliefs over six months.
• Willingness to change treatment was measured alongside disease activity and belief questionnaires.
• Linear mixed models were used to analyze the relationships between these variables.

Main Results:

• Willingness to change treatment showed a strong, direct association with disease activity scores.
• Illness beliefs did not significantly influence willingness to change when disease activity was considered.
• The number of self-reported symptoms directly correlated with the willingness to modify treatment.

Conclusions:

• Concerns regarding patient ability to participate in collaborative T2T were not supported by the findings.
• Disease activity, particularly self-reported symptoms, is a primary driver of treatment change willingness.
• Future research should explore the nuanced interactions within clinical decision-making processes for T2T.