Exploring Information Needs and Perspectives on a Patient Decision Aid for Biologic Therapy: A Qualitative Interview...

Significant advances in therapeutic and management options have been made for rheumatoid arthritis (RA), including the development of biologics. However, some patients have expressed hesitancy with respect to their use. We aimed to (1) investigate RA patient perspectives on a biologic patient decision aid; and (2) explore how this decision aid addressed their broader information needs in a US healthcare context.

We conducted in-depth telephone interviews with RA patients who were considering either initiating a biologic for the first time or switching to another biologic. Participants were recruited from across the US by a research coordinator based at Massachusetts General Hospital. Participants were first invited to access an existing decision aid developed to support individuals with RA who are considering a biologic. We conducted an iterative content analysis guided by the grounded theory approach.

We interviewed 14 patients with RA, among whom five were biologic-naive. We identified four major themes: 1) treatment-related information seeking behavior (including connecting with others with a chronic disease); 2) helpful aspects of the decision aid (including access to patient stories); 3) decision aid limitations and potential solutions (including content preferences and accessibility); and 4) impacts on the decision to initiate a biologic (including empowerment to engage in shared decision-making).

These four themes highlight key factors to consider for the design/refinement and implementation of patient decision aids in the US (including key information needs and the utility of patient stories) to appropriately meet the needs of patients who are considering a biologic.