Evidence map›Paper›PMID 39666735›Full record

ArticlePloS one2024

The choice of treatment and the motivations behind it impact clinical outcomes among patients with adequate control of their rheumatic disease: A real-life study.

Irazú Contreras-Yáñez, Guillermo A Guaracha-Basáñez, Diana Padilla-Ortiz, Laura L Franco-Mejía, Laura V Vargas-Sánchez, Julia G Jiménez-Decle, Virginia Pascual-Ramos

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Irazú Contreras-YáñezDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.
Guillermo A Guaracha-BasáñezDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.ORCID 0000-0001-8060-7301
Diana Padilla-OrtizDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.
Laura L Franco-MejíaDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.
Laura V Vargas-SánchezDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.
Julia G Jiménez-DecleDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.
Virginia Pascual-RamosDepartment of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán (INCMyN-SZ), Mexico City, Mexico.ORCID 0000-0002-7368-498X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMany factors influence how doctors make treatment decisions. The study compares the outcomes of patients with rheumatic diseases and adequate control (AC) whose treating rheumatologists prescribed their first choice of treatment (FCHO) versus the second choice (SCHO) and the motivations behind them. It also investigates the motivations associated with FCHO. PATIENTS AND

methodsThe study was conducted at an outpatient clinic from February 2023 to February 2024. Patients with an RMD diagnosis were identified using systematic sampling (P-1). After their consultation, their rheumatologists detailed their treatment choice (FCHO vs. SCHO), the motivations behind it, and the outcomes. In a subsample of patients from P-1 and AC (SubP-1), treating rheumatologists repeated the assessment of outcomes at the next scheduled consultation. Descriptive statistics and multivariate regression analysis were used.

resultsThere were 703 patients enrolled (P-1), 543 (77.2%) had AC, and 292 (Subp-1) underwent a follow-up evaluation. In P-1 and subP-1, FCHO was prescribed to 644 (91.5%) and 269 (92.1%) patients. Motivations related to evidence-based medicine and personal experience were more frequently referred to in FCHO. Concerns related to current or future drug shortages and a history of adverse events/intolerance were more frequent in SCHO. In SubP-1, a higher proportion of patients remained in AC and experienced remission/ improved disease activity with FCHO. Patients who received FCHO experienced a greater risk for favorable outcomes. The following motivations were associated with FCHO: "It aligns with guidelines"; "solid scientific evidence supporting the treatment effectiveness"; "I am concerned that the shortage of the drug may hinder the continuation of the treatment" and "history of adverse events or intolerance".

conclusionsPatients with AC of their underlying RMD, whose rheumatologists prescribed their FCHO, had better outcomes than those who were prescribed SCHO. Evidence-based motivations, rheumatologists´ concern of medication shortage, and patient-related motivations were associated with FCHO.

Indexed as

MotivationRheumatic DiseasesAdultAgedAntirheumatic AgentsFemaleHumansMaleMiddle AgedTreatment OutcomeAntirheumatic Agents

Identifiers

PMID39666735
PMCPMC11637349

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.