title: Integrating patients' perceptions into clinical practice guidelines for the management of rheumatoid arthritis in Japan.
abstract: OBJECTIVE
  Patients' values and preferences are among the key factors that determine the strength of recommendations presented in clinical practice guidelines (CPG). The aim of this study was to summarize the integration process for patients' perceptions into the development of CPG for rheumatoid arthritis (RA) management in Japan.
  
  
  METHODS
  We used a mixed-methods approach. Questionnaires that could be self-administered were mailed to 2222 RA patients randomly selected from the Japan Rheumatism Friendship Association (JRFA) membership list that was age- and prefecture-stratified. A focus group with five JRFA executive members was formed to verify the results of the questionnaire.
  
  
  RESULTS
  A total of 1470 patients aged 20-79 years old returned the questionnaire. Analysis of the questionnaire data revealed that the topics selected by the CPG task force met the patients' needs. The focus group participants showed reluctance to use the term 'preference' because patients would not want to take any medications but would have to take them out of necessity.
  
  
  CONCLUSIONS
  We confirmed that the new CPG successfully addressed clinical issues that were important to both rheumatologists and patients. Clinicians should understand patients' reluctance to take medications and explain the role of each medication well to increase adherence.
authors.affiliation: a Department of Medical Education , Nagoya City University Graduate School of Medical Sciences , Nagoya , Japan.
authors.forename: Masayo
authors.initials: M
authors.lastname: Kojima
authors.affiliation: b Department of Health Informatics , Kyoto University School of Public Health , Kyoto , Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.affiliation: c Department of Educational Sciences , Nagoya University Graduate School of Education and Human Development, Nagoya, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Otani
authors.affiliation: d The Japan Rheumatism Friendship Association, Tokyo, Japan.
authors.forename: Mieko
authors.initials: M
authors.lastname: Hasegawa
authors.affiliation: e Inflammation and Immunology, Graduate School of Medical Science , Kyoto Prefectural University of Medicine , Kyoto , Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kawahito
authors.affiliation: f Division of Rheumatology, Department of Internal Medicine , Keio University School of Medicine , Tokyo , Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kaneko
authors.affiliation: g Immuno-Rheumatology Center, St Luke's International Hospital , Tokyo , Japan.
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Kishimoto
authors.affiliation: h The First Department of Internal Medicine, School of Medicine , University of Occupational and Environmental Health , Kitakyushu , Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Hirata
authors.affiliation: i Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Seto
authors.affiliation: j Division of Rheumatology, Department of Internal Medicine, School of Medicine , Toho University, Tokyo , Japan.
authors.forename: Hirahito
authors.initials: H
authors.lastname: Endo
authors.affiliation: k Department of Orthopaedic Surgery , Kyoto University Graduate School of Medicine , Kyoto , Japan.
authors.forename: Hiromu
authors.initials: H
authors.lastname: Ito
authors.affiliation: l Department of Orthopedic Surgery , Nagoya University Hospital , Nagoya , Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Kojima
authors.affiliation: m Department of Human Morphology , Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences , Okayama , Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.affiliation: n Department of Orthopaedic Surgery, Faculty of Medicine , University of Toyama , Toyama , Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Matsushita
authors.affiliation: o Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences , The University of Tokyo , Tokyo , Japan.
authors.forename: Kiichiro
authors.initials: K
authors.lastname: Tsutani
authors.affiliation: o Department of Drug Policy and Management, Graduate School of Pharmaceutical Sciences , The University of Tokyo , Tokyo , Japan.
authors.forename: Ataru
authors.initials: A
authors.lastname: Igarashi
authors.affiliation: i Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Kamatani
authors.affiliation: p Department of Rheumatology, Tokyo Medical and Dental University , Tokyo , Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Miyasaka
authors.affiliation: i Institute of Rheumatology, Tokyo Women's Medical University , Tokyo , Japan.
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yamanaka
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D010465:Perception; D017410:Practice Guidelines as Topic
chemical_list: D018501:Antirheumatic Agents
keywords: Rheumatoid arthritis; clinical practice guidelines; focus group; patients’ perspectives; questionnaire survey