Study Identifies 5 Key Values of Quality Care for Patients With Rheumatoid Arthritis

The idea of quality care for rheumatoid arthritis (RA) often varies among the patient, clinician, and healthcare provider. However, there is a lack of representation of the patient’s perspective involved in the quality indicators that are the current standards for RA outcomes.

A study published by Rheumatic & Musculoskeletal Diseases utilized a focus group and an online survey of patients with RA to gather data that represented their perspective of their care. The 6 patients included in the phase 1 focus group were asked for their positive and negative experiences involving their rheumatology care.

Participants also ranked 3 elements that they considered most important for their care, and were separated into smaller groups based on their answers. This was completed with a vote by the entire group to determine the most important domains.

The remaining domains were presented to 1132 patients with RA for the phase 2 survey. The patients were instructed to score the domains based on their importance while prioritizing 5 specific domains as the most important in rheumatology care.

The top 5 domains to evaluate the quality of care from the patient’s perspective, following the survey and focus group, were determined to be:

1. Adjustment of therapy based on activity of the disease
2. Interest in the personal life of patients
3. Shared decision making
4. Education of the course of the disease
5. Insight in medication and comorbidity

The researchers acknowledged that these top 5 domains are all process measures, while providers often hold a greater value on the outcome. This implies that patient satisfaction relies less heavily on the actual outcome of their care than the process to that point.

“Although the current opinion has shifted from process measurement towards outcome measurement, recent insights again highlight the importance of process indicators that are pivotal to change outcomes,” the authors wrote. “Since process measures are easier to identify and change, they have been suggested to be more appropriate for quality improvement than outcome measures.”

The researchers were able to narrow the patient perspective to a set of 5 key processes that are important in rheumatology care. Future research is necessary to further capture the patient perspective through a questionnaire for use in quality registries.