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Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists

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  • Márta Péntek
  • László Gulácsi
  • Bernadette Rojkovich
  • Valentin Brodszky
  • Job Exel
  • Werner Brouwer

Abstract

Subjective health expectations of patients with rheumatoid arthritis (RA) and rheumatologists remain understudied. We measured subjective expectations regarding treatment effects of biologicals as well as future length and quality of life. Moreover, we compared expectations regarding treatment effects to actual treatment effects. We recruited a sample of Hungarian RA patients initiating treatment with biologicals. Expectations regarding treatment effects and future health were obtained through a written questionnaire from patients and physicians, including functional impairment (HAQ-DI), health status (EQ-5D) and disease activity (DAS28). After three months, actual treatment effects were obtained. Ninety-two RA patients (females N = 81, 88 %) with mean age of 51 (SD 12) and disease duration of 9 (SD 8) years with high average disease activity (DAS28: 6.1) were included. Patients expected significant and large health improvement within three months with mean changes on the HAQ-DI of −0.8 and on the EQ-5D of +0.4. Rheumatologists’ estimates were similar, and they expected significant decrease of 2.3 on the DAS28. Actual scores after three months were obtained for 77 patients. The measured scores were significantly lower than expected scores for the HAQ-DI and EQ-5D. Rheumatologists’ expectations for the DAS28 score were not significantly different from measured scores. Patients’ average expectations regarding quality of life scores for ages 60, 70, 80 and 90 were 0.44, 0.24, 0.06 and −0.02, respectively. Our results suggest that both RA patients and rheumatologists expect quick and significant health improvements from biological drugs and tend to overestimate actual short term treatment effects. Nonetheless, RA patients expect a sharp deterioration of future health. Copyright Springer-Verlag Berlin Heidelberg 2014

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  • Márta Péntek & László Gulácsi & Bernadette Rojkovich & Valentin Brodszky & Job Exel & Werner Brouwer, 2014. "Subjective health expectations at biological therapy initiation: a survey of rheumatoid arthritis patients and rheumatologists," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 83-92, May.
    • Handle: RePEc:spr:eujhec:v:15:y:2014:i:1:p:83-92
    DOI: 10.1007/s10198-014-0597-1
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    1. Brouwer, Werner B.F. & van Exel, N. Job A., 2005. "Expectations regarding length and health related quality of life: Some empirical findings," Social Science & Medicine, Elsevier, vol. 61(5), pages 1083-1094, September.
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    3. J. Lundkvist & F. Kastäng & G. Kobelt, 2008. "The burden of rheumatoid arthritis and access to treatment: health burden and costs," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 49-60, January.
    4. Mirowsky, John, 1999. "Subjective life expectancy in the US: correspondence to actuarial estimates by age, sex and race," Social Science & Medicine, Elsevier, vol. 49(7), pages 967-979, October.
    5. Marra, Carlo A. & Woolcott, John C. & Kopec, Jacek A. & Shojania, Kamran & Offer, Robert & Brazier, John E. & Esdaile, John M. & Anis, Aslam H., 2005. "A comparison of generic, indirect utility measures (the HUI2, HUI3, SF-6D, and the EQ-5D) and disease-specific instruments (the RAQoL and the HAQ) in rheumatoid arthritis," Social Science & Medicine, Elsevier, vol. 60(7), pages 1571-1582, April.
    6. J. Lundqvist & F. Kastäng & G. Kobelt & B. Jönsson, 2008. "The burden of rheumatoid arthritis and access to treatment: determinants of access," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 87-93, January.
    7. G. Kobelt & B. Jönsson, 2008. "The burden of rheumatoid arthritis and access to treatment: outcome and cost-utility of treatments," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 8(2), pages 95-106, January.
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    1. Márta Péntek & Ottó Hajdu & Fanni Rencz & Zsuzsanna Beretzky & Valentin Brodszky & Petra Baji & Zsombor Zrubka & Klára Major & László Gulácsi, 2019. "Subjective expectations regarding ageing: a cross-sectional online population survey in Hungary," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(1), pages 17-30, June.
    2. Márta Péntek & Bernadette Rojkovich & László Czirják & Pál Géher & Péter Keszthelyi & Attila Kovács & László Kovács & Zita Szabó & Zoltán Szekanecz & László Tamási & Ágnes Tóth & Ilona Ujfalussy & Noé, 2014. "Acceptability of less than perfect health states in rheumatoid arthritis: the patients’ perspective," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(1), pages 73-82, May.

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    More about this item

    Keywords

    Arthritis; rheumatoid; Biological drugs; Health expectations; EQ-5D; Hungary; I19;
    All these keywords.

    JEL classification:

    • I19 - Health, Education, and Welfare - - Health - - - Other

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