Subjective health expectations at biological therapy initiation

A survey of rheumatoid arthritis patients and rheumatologists

Márta Péntek, L. Gulácsi, Bernadette Rojkovich, Valentin Brodszky, Job Van Exel, Werner B F Brouwer

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Subjective health expectations of patients with rheumatoid arthritis (RA) and rheumatologists remain understudied. We measured subjective expectations regarding treatment effects of biologicals as well as future length and quality of life. Moreover, we compared expectations regarding treatment effects to actual treatment effects. We recruited a sample of Hungarian RA patients initiating treatment with biologicals. Expectations regarding treatment effects and future health were obtained through a written questionnaire from patients and physicians, including functional impairment (HAQ-DI), health status (EQ-5D) and disease activity (DAS28). After three months, actual treatment effects were obtained. Ninety-two RA patients (females N = 81, 88%) with mean age of 51 (SD 12) and disease duration of 9 (SD 8) years with high average disease activity (DAS28: 6.1) were included. Patients expected significant and large health improvement within three months with mean changes on the HAQ-DI of -0.8 and on the EQ-5D of +0.4. Rheumatologists' estimates were similar, and they expected significant decrease of 2.3 on the DAS28. Actual scores after three months were obtained for 77 patients. The measured scores were significantly lower than expected scores for the HAQ-DI and EQ-5D. Rheumatologists' expectations for the DAS28 score were not significantly different from measured scores. Patients' average expectations regarding quality of life scores for ages 60, 70, 80 and 90 were 0.44, 0.24, 0.06 and -0.02, respectively. Our results suggest that both RA patients and rheumatologists expect quick and significant health improvements from biological drugs and tend to overestimate actual short term treatment effects. Nonetheless, RA patients expect a sharp deterioration of future health.

Original languageEnglish
JournalEuropean Journal of Health Economics
Volume15
Issue numberSUPPL. 1
DOIs
Publication statusPublished - 2014

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Diagnostic Self Evaluation
Biological Therapy
Rheumatoid Arthritis
ametantrone
Health
Therapeutics
Quality of Life
Rheumatologists
Surveys and Questionnaires
Therapy
Arthritis
Subjective health
Health Status
Treatment effects
Physicians

Keywords

  • Arthritis, rheumatoid
  • Biological drugs
  • EQ-5D
  • Health expectations
  • Hungary

ASJC Scopus subject areas

  • Health Policy
  • Economics, Econometrics and Finance (miscellaneous)
  • Medicine(all)

Cite this

Subjective health expectations at biological therapy initiation : A survey of rheumatoid arthritis patients and rheumatologists. / Péntek, Márta; Gulácsi, L.; Rojkovich, Bernadette; Brodszky, Valentin; Van Exel, Job; Brouwer, Werner B F.

In: European Journal of Health Economics, Vol. 15, No. SUPPL. 1, 2014.

Research output: Contribution to journalArticle

Péntek, Márta ; Gulácsi, L. ; Rojkovich, Bernadette ; Brodszky, Valentin ; Van Exel, Job ; Brouwer, Werner B F. / Subjective health expectations at biological therapy initiation : A survey of rheumatoid arthritis patients and rheumatologists. In: European Journal of Health Economics. 2014 ; Vol. 15, No. SUPPL. 1.
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