Willingness to accept risk in the treatment of rheumatic disease.
Adult
Arthritis, Rheumatoid
03 medical and health sciences
Risk-Taking
0302 clinical medicine
Humans
Spondylitis, Ankylosing
Middle Aged
Patient Acceptance of Health Care
Attitude to Health
Choice Behavior
3. Good health
DOI:
10.1136/jech.44.3.249
Publication Date:
2008-11-12T20:10:54Z
AUTHORS (3)
ABSTRACT
The aim was to assess patients willingness to accept mortal risk in the drug treatment of chronic rheumatic disease.A non-random sample of consecutive patients were interviewed with a standardised survey instrument.The study took place in the Royal National Hospital for Rheumatic Diseases, Bath, UK.100 consecutive in- and out-patients aged 65 or less were interviewed, 50 with rheumatoid arthritis and 50 with ankylosing spondylitis. Mean age was 48 years with mean disease duration of 14 years. The rheumatoid arthritis group was mainly female (84%), v 26% in the ankylosing spondylitis group.Risk preferences were elicited using the method of standard gamble in the context of a hypothetical new drug. Patients indicated the maximum percentage probability of mortality they regarded as acceptable to achieve four different levels of benefit: total cure (20.7%), relief of pain (16.9%), relief of stiffness (13.1%), return to normal functioning (14.5%). Rheumatoid arthritis patients displayed a higher (p less than 0.05) willingness to accept risk than ankylosing spondylitis patients for all gambles except relief of stiffness. Analysis of variance indicated that willingness to accept risk decreases with the duration of disease and increases with reductions in self assessed health status.Evaluative methods such as standard gamble can elicit useful risk-benefit preference data from patients to assist those who manage clinical risks.
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