title: Patient decision-making related to antirheumatic drugs in rheumatoid arthritis: the importance of patient trust of physician.
abstract: OBJECTIVE
  To explore how rheumatoid arthritis (RA) antirheumatic drug-specific knowledge and numeric literacy, patient trust in physician, and demographic and disease-related factors relate to the confidence of patient decision-making related to disease modifying antirheumatic drugs (DMARD).
  
  
  METHODS
  Data were analyzed from 628 randomly selected patients with RA receiving care in community rheumatology practices, who responded to a multicenter, cross-sectional mail survey. We used multiple regression models to predict patient confidence in DMARD decision-making related to their most recently initiated DMARD.
  
  
  RESULTS
  Significant positive correlation was found between confidence in DMARD decision and trust in physician, DMARD-specific knowledge, and disease duration, but not risk-related numeric literacy, sex, or education. Negative correlations were found with disease severity and current bother with DMARD side effects. A multiple linear regression model of confidence in DMARD decision had an overall R = 0.788, R2 = 0.620 (p < 0.001). The 4 dependent variables contributing significantly to the model were female sex, Medicaid insurance status, satisfaction with RA disease control, and trust in physician, with standardized beta = 0.077, -0.089, 0.147, and 0.687, respectively.
  
  
  CONCLUSIONS
  In this sample of community patients with RA, the patient trust in physician had substantially greater effect on confidence in DMARD decision than DMARD-specific knowledge, disease-related factors, or demographic characteristics.
authors.affiliation: Departments of Medicine and Rheumatology, College of Human Medicine, Michigan State University, Grand Rapids, Michgan 49546, USA. martin@mi-arthritis.com
authors.forename: Richard W
authors.initials: RW
authors.lastname: Martin
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Head
authors.forename: Jonathan
authors.initials: J
authors.lastname: René
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Swartz
authors.forename: Justus J
authors.initials: JJ
authors.lastname: Fiechtner
authors.forename: Barbara A
authors.initials: BA
authors.lastname: McIntosh
authors.forename: Margaret
authors.initials: M
authors.lastname: Holmes-Rovner
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000523:psychology*; D002755:Choice Behavior; D003625:Data Collection; D003657:Decision Making; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation / Q000523:psychology*; D010817:Physician-Patient Relations
chemical_list: D018501:Antirheumatic Agents