Tsuboi Hiroto, Kaneko Yuko, Ikeda Kei, Aranishi Toshihiko, Cai Zhihong, Ishizuka Tomoko
Department of Internal Medicine, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
Division of Rheumatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Curr Med Res Opin. 2022 May;38(5):853-861. doi: 10.1080/03007995.2022.2050108. Epub 2022 Mar 24.
To assess the current status of shared decision making (SDM) in rheumatoid arthritis (RA) clinical practice in Japan from the perspectives of physicians and patients.
A web-based survey was conducted to recruit patients with RA who were prescribed, for the first time, a conventional synthetic disease-modifying antirheumatic drug (csDMARD) or a biological drug/Janus kinase (JAK) inhibitor, and physicians who prescribed these treatments to patients with RA. The SDM Questionnaire-Physician version (SDM-Q-Doc) and the 9-item SDM Questionnaire (SDM-Q-9) were used to assess the SDM levels of physicians and patients, respectively. The scale ranged from 0 to 100, and higher scores indicated better SDM status.
The responses from 107 physicians who treat patients with RA, 107 patients prescribed a csDMARD, and 110 patients prescribed a biological drug/JAK inhibitor were collected. The mean SDM score for SDM-Q-Doc was 74.5 when physicians decided to prescribe a csDMARD and 77.2 when they decided to prescribe a biological drug/JAK inhibitor. However, the mean SDM score for SDM-Q-9 was 62.3 when patients were prescribed csDMARDs and 72.6 when they were prescribed biological drugs/JAK inhibitors.
The results showed differences in SDM level between patients and physicians and, from the patient perspective, between treatment types.
从医生和患者的角度评估日本类风湿关节炎（RA）临床实践中共同决策（SDM）的现状。
开展一项基于网络的调查，招募首次接受传统合成抗风湿药物（csDMARD）或生物药物/Janus激酶（JAK）抑制剂治疗的RA患者，以及为RA患者开具这些治疗药物的医生。分别使用共同决策问卷-医生版（SDM-Q-Doc）和9项共同决策问卷（SDM-Q-9）评估医生和患者的共同决策水平。评分范围为0至100分，分数越高表明共同决策状态越好。
收集了107名治疗RA患者的医生、107名接受csDMARD治疗的患者以及110名接受生物药物/JAK抑制剂治疗的患者的回复。当医生决定开具csDMARD时，SDM-Q-Doc的平均共同决策得分为74.5分；当医生决定开具生物药物/JAK抑制剂时，平均得分为77.2分。然而，当患者接受csDMARD治疗时，SDM-Q-9的平均共同决策得分为62.3分；当患者接受生物药物/JAK抑制剂治疗时，平均得分为72.6分。
结果显示患者和医生之间以及从患者角度来看不同治疗类型之间的共同决策水平存在差异。
