Background Increasing importance is being given to a shared medical decision making (DM) process. However, not all patients desire the same level of participation in medical DM.1 There are no studies exploring desires of Maltese patients with rheumatic diseases regarding informed consent and medical DM.
Objectives To explore whether Maltese patients with rheumatic diseases wish to be informed about potentially serious adverse events of corticosteroids, DMARDs and biological agents, and to be involved in the medical DM process.
Methods Questionnaire completed by Maltese patients attending a Rheumatology Out-Patient Clinic. Aspects covered included Demographic data, Desires for (a) information about disease, (b) Knowledge of drug adverse events (DAEs) (c) involvement in DM Process.
Results 196 participants; Mean age 62 years; 69% female; 42% had a primary level of education.
Participant self-assessment of knowledge of disease: 19% claimed sufficient knowledge (median age 60 years); 42% felt the need to know more (median age 61 years); 38% desired no knowledge since their doctor knew best. The latter tended to be older (p=0.002, median age 65 years).
Desire for Knowledge of DAEs: 56% wanted information about all DAEs; 34% wanted some information and 16% wanted no information. The latter tended to be older (p=0.004, median age 65 years), and had a lower level of education (p=0.06).
Desire for a Choice of Treatment and Involvement in DM Process: 54% wanted rheumatologist to decide on treatment; 30% wanted a discussion on best treatment options; 16% preferred to choose treatment without physician indicating best option.
50% of females compared to 36% of males wanted at least some level of involvement in DM process (p=0.058). This group also tended to be younger (p=0.002, median age 60 vs 65 years). 71% of those with a post-secondary/tertiary level of education wished to participate in the DM process compared to 41% of those with a secondary school level of education or less (p=0.02).
73% of those who did not want to be involved in the DM process still wished to be informed about DAEs at least to some degree.
Conclusions Information on DAEs is important for Maltese patients with rheumatic diseases. However the desire for information is not reflected in a desire for involvement in the DM process. Whilst there are many benefits of shared DM, rheumatologists must do their best to understand and respect patient individual preferences.
R Neame et al. Need for Information and for Involvement in Decision Making Among Patients with Rheumatoid Arthritis: A Questionnaire Survey. Arthritis Rheum (Arthritis Care & Res); 2005;53:249–255.
Disclosure of Interest None Declared