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Continued Participation in a Ten‐Year Tight Control Treat‐to‐Target Study in Rheumatoid Arthritis: Why Keep Patients Doing their Best?
Author(s) -
Markusse Iris M.,
Dirven Linda,
Han K. Huub,
Ronday H. Karel,
Kerstens Pit J. S. M.,
Lems Willem F.,
Huizinga Tom W. J.,
Allaart Cornelia F.
Publication year - 2015
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22540
Subject(s) - medicine , hazard ratio , confidence interval , rheumatoid arthritis , adverse effect , proportional hazards model , physical therapy
Objective To identify risk factors for early study termination and motivators for adherence to a long‐term followup trial and to improve completeness of long‐term studies. Methods Risk factors for early termination in 508 included patients were identified through Cox regression analysis. Patients completing the 10‐year followup filled in a questionnaire on possible motives for continued study participation. Results Risk factors for early termination were higher age (hazard ratio [HR] 1.03, 95% confidence interval [95% CI] 1.02–1.04), functional disability during the preceding year (HR 1.54, 95% CI 1.20–1.99), having achieved drug‐free remission (HR 6.62, 95% CI 2.07–21.14), limited joint damage (HR 0.98, 95% CI 0.97–0.995 for actual damage; HR 0.83, 95% CI 0.73–0.94 for damage progression), and few adverse events (HR 0.35, 95% CI 0.26–0.47). A total of 288 of 313 patients (92%) attending the last visit answered the questionnaire. The majority mentioned contributing to scientific research (97% agreed), helping other patients (91%), and learning about new treatment strategies (84%) and their disease (85%) as reasons to continue participation. Next, patients mentioned tight control (202 of 278 patients), good treatment strategy (128 of 278), good medication (117 of 278), and good half‐term results (102 of 278) as motivators. More than 95% of patients experienced participation “as expected” or “better than expected.” Additional examinations during yearly visits (extra questionnaires, imaging) were mentioned as “worse than expected” (10%), as was answering routine questionnaires (7%). Conclusion Continued participation was relatively high in the Treatment Strategies for Rheumatoid Arthritis (BeSt) Study. Higher age, functional disability, drug‐free remission, little joint damage, and few adverse events predicted early study termination. Main motives for continued participation were a willingness to contribute to research, help future patients, and because patients had good experiences with the study protocol.