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Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis

BACKGROUND: Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of rheumatoid arthritis (RA) treatment. However, the full benefits of DMARDs are often not realized because many patients are sub-optimally adherent to their medication. In order to optimize adherence, it is essential th...

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Autores principales: Voshaar, M. J. H., van den Bemt, B. J. F., van de Laar, M. A. F. J., van Dulmen, A. M., Vriezekolk, J. E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756692/
https://www.ncbi.nlm.nih.gov/pubmed/35022034
http://dx.doi.org/10.1186/s12913-021-07459-0
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author Voshaar, M. J. H.
van den Bemt, B. J. F.
van de Laar, M. A. F. J.
van Dulmen, A. M.
Vriezekolk, J. E.
author_facet Voshaar, M. J. H.
van den Bemt, B. J. F.
van de Laar, M. A. F. J.
van Dulmen, A. M.
Vriezekolk, J. E.
author_sort Voshaar, M. J. H.
collection PubMed
description BACKGROUND: Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of rheumatoid arthritis (RA) treatment. However, the full benefits of DMARDs are often not realized because many patients are sub-optimally adherent to their medication. In order to optimize adherence, it is essential that healthcare professionals (HCPs) understand patients’ barriers and facilitators for medication use. Insight in these barriers and facilitators may foster the dialogue about adequate medication use between HCPs and patients. What HCPs perceive as barriers and facilitators has, so far, scarcely been investigated. This study aimed to identify the perceptions of HCPs on patients’ barriers and facilitators that might influence their adherence. METHODS: This qualitative study was performed using semi structured in-depth interviews with HCPs. An interview guide was used, based on an adjusted version of the Theoretical Domains Framework (TDF). Thematic analysis was conducted to identify factors that influence barriers and facilitators to DMARD use according to HCPs. RESULTS: Fifteen HCPs (5 rheumatologists, 5 nurses and 5 pharmacists) were interviewed. They mentioned a variety of factors that, according to their perceptions, influence DMARD adherence in patients with RA. Besides therapy-related factors, such as (onset of) medication effectiveness and side-effects, most variation was found within patient-related factors and reflected patients’ beliefs, ways of coping, and (self-management) skills toward medication and their condition. In addition, factors related to the condition (e.g., level of disease activity), healthcare team and system (e.g., trust in HCP), and social and economic context (e.g. support, work shifts) were reported. CONCLUSIONS: This study provided insights in HCPs’ perceptions of the barriers and facilitators to DMARD use patients with RA. Most factors that were mentioned were patient-related and potentially modifiable. When physicians understand patients’ perceptions on medication use, adherence to DMARDs can probably be optimized in patients with RA leading to more effectiveness of treatment outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07459-0.
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spelling pubmed-87566922022-01-18 Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis Voshaar, M. J. H. van den Bemt, B. J. F. van de Laar, M. A. F. J. van Dulmen, A. M. Vriezekolk, J. E. BMC Health Serv Res Research BACKGROUND: Disease-modifying anti-rheumatic drugs (DMARDs) are the cornerstone of rheumatoid arthritis (RA) treatment. However, the full benefits of DMARDs are often not realized because many patients are sub-optimally adherent to their medication. In order to optimize adherence, it is essential that healthcare professionals (HCPs) understand patients’ barriers and facilitators for medication use. Insight in these barriers and facilitators may foster the dialogue about adequate medication use between HCPs and patients. What HCPs perceive as barriers and facilitators has, so far, scarcely been investigated. This study aimed to identify the perceptions of HCPs on patients’ barriers and facilitators that might influence their adherence. METHODS: This qualitative study was performed using semi structured in-depth interviews with HCPs. An interview guide was used, based on an adjusted version of the Theoretical Domains Framework (TDF). Thematic analysis was conducted to identify factors that influence barriers and facilitators to DMARD use according to HCPs. RESULTS: Fifteen HCPs (5 rheumatologists, 5 nurses and 5 pharmacists) were interviewed. They mentioned a variety of factors that, according to their perceptions, influence DMARD adherence in patients with RA. Besides therapy-related factors, such as (onset of) medication effectiveness and side-effects, most variation was found within patient-related factors and reflected patients’ beliefs, ways of coping, and (self-management) skills toward medication and their condition. In addition, factors related to the condition (e.g., level of disease activity), healthcare team and system (e.g., trust in HCP), and social and economic context (e.g. support, work shifts) were reported. CONCLUSIONS: This study provided insights in HCPs’ perceptions of the barriers and facilitators to DMARD use patients with RA. Most factors that were mentioned were patient-related and potentially modifiable. When physicians understand patients’ perceptions on medication use, adherence to DMARDs can probably be optimized in patients with RA leading to more effectiveness of treatment outcomes. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-07459-0. BioMed Central 2022-01-13 /pmc/articles/PMC8756692/ /pubmed/35022034 http://dx.doi.org/10.1186/s12913-021-07459-0 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Voshaar, M. J. H.
van den Bemt, B. J. F.
van de Laar, M. A. F. J.
van Dulmen, A. M.
Vriezekolk, J. E.
Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title_full Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title_fullStr Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title_full_unstemmed Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title_short Healthcare professionals’ perceptions on barriers and facilitators to DMARD use in rheumatoid arthritis
title_sort healthcare professionals’ perceptions on barriers and facilitators to dmard use in rheumatoid arthritis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756692/
https://www.ncbi.nlm.nih.gov/pubmed/35022034
http://dx.doi.org/10.1186/s12913-021-07459-0
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