title: A Nationwide Survey on Patient's versus Physician´s Evaluation of Biological Therapy in Rheumatoid Arthritis in Relation to Disease Activity and Route of Administration: The Be-Raise Study.
abstract: OBJECTIVE
  Biological treatment of rheumatoid arthritis (RA) is one of the cornerstones of current treatment strategies for the disease. Surprisingly little information exists on whether the route of administration affects patients' treatment satisfaction. It is equally unclear whether rheumatologists are able to accurately perceive their patients' appreciation. Thus, the Belgian Be-raise survey aimed to examine whether RA patient's experience of their current biological treatment coincided with the treating physician's perception.
  
  
  METHODS
  A nationwide cross-sectional survey was conducted by 67 Belgian rheumatologists providing data obtained from 550 RA patients. Patients under stable dose of biologics for at least 6 months, were enrolled consecutively and all completed questionnaires. Separate questionnaires were completed by the treating rheumatologist which evaluated their patient's perception of the route of treatment administration. This study therefore evaluates whether a treating physician perceives the satisfaction with the route of administration to the same degree as the patient.
  
  
  RESULTS
  Completed questionnaires were obtained from 293 and 257 patients who obtained treatment via the intravenous (IV) or subcutaneous (SC) route of administration, respectively. 58.4% of patients were in DAS28-CRP(3) remission. Patient satisfaction with disease control was higher (44% scored ≥ 9) than that of the treating physician (35%), regardless of the route of administration (p< 0.01). No differences were seen for the patients treated with an IV as opposed to a SC route of administration. The physician´s perception of patient's satisfaction with disease control was markedly lower for IV treated patients as opposed to SC treated patients (p< 0.001).
  
  
  CONCLUSIONS
  Patients' satisfaction with biological treatment is high, but there is a considerable mismatch between patients´ and rheumatologists´ appreciation on the route of administration of biological therapy in RA. Physicians consistently consider IV biological therapy to be less satisfactory. Patient´s appreciation is largely dependent on disease control, irrespective of the route of administration. Therefore, and encouraging shared decision making, we suggest that physicians and patients discuss the route of administration of biologicals in an open way.
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Sophie
authors.identifier: http://orcid.org/0000-0003-4541-9895
authors.initials: S
authors.lastname: De Mits
authors.affiliation: Department of Rheumatology, Reuma-Instituut Hasselt, Leuven University Hospital, Leuven, Belgium.
authors.forename: Jan
authors.initials: J
authors.lastname: Lenaerts
authors.affiliation: Department of Rheumatology, Sint Jozef Hospital Bornem, OLV Hospital Aalst, Aalst, Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Vander Cruyssen
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Mielants
authors.affiliation: Skeletal Biology and Engineering Research Center, Department of Development and Regeneration KU Leuven; Rheumatology, University Hospitals Leuven, Leuven, Belgium.
authors.forename: René
authors.initials: R
authors.lastname: Westhovens
authors.affiliation: Department of Rheumatology, Université Catholique de Louvain UCL, Louvain-la-Neuve, Belgium.
authors.forename: Patrick
authors.initials: P
authors.lastname: Durez
authors.affiliation: Department of Rheumatology, Ghent University Hospital, Ghent, Belgium.|Laboratory of Molecular Immunology and Inflammation, VIB Inflammation Research Center, Ghent University, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Elewaut
mesh_terms: D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000473:pathology / Q000523:psychology*; D001688:Biological Products / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010820:Physicians / Q000523:psychology*; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D001688:Biological Products