OBJECTIVES: Therapeutic decisions in osteoarthritis (OA) often involve trade-offs between accepting risks of side effects and gaining pain relief. Our objectives were (1) to determine patients' maximum acceptable risk increments (MARI) for different adverse effects from OA medication and (2) to identify the predictors of these preferences. STUDY DESIGN AND SETTING: MARI were measured with a probabilistic threshold technique (TT). Risk and pain levels in the TT scenarios were controlled for in a 2x2 randomized factorial design. Clinical, sociodemographic, and psychological characteristics (decisional conflict and locus of control) of the participants were assessed using a self-administered questionnaire. RESULTS: For 196 subjects, MARI varied by type of adverse effect, level of pain relief, and baseline risk. Mean MARI ranged from 3% to 5% for heart attack/stroke, 5% to 8% for stomach bleed, 13% to 21% for hypertension, 22% to 33% for fluid retention, and 23% to 35% for dyspepsia. Age, gender, education, physical and mental health, pain, disability, and locus of control were not associated with MARI. CONCLUSION: Participants varied widely in the level of risk they would accept, but their clinical, sociodemographic, and psychological characteristics did not explain this variation. These observations are important for the development of practice guidelines for physicians and patients' decision aids that can foster individualized, evidence-based yet preference-sensitive care for patients with OA.
RCT Entities:
OBJECTIVES: Therapeutic decisions in osteoarthritis (OA) often involve trade-offs between accepting risks of side effects and gaining pain relief. Our objectives were (1) to determine patients' maximum acceptable risk increments (MARI) for different adverse effects from OA medication and (2) to identify the predictors of these preferences. STUDY DESIGN AND SETTING: MARI were measured with a probabilistic threshold technique (TT). Risk and pain levels in the TT scenarios were controlled for in a 2x2 randomized factorial design. Clinical, sociodemographic, and psychological characteristics (decisional conflict and locus of control) of the participants were assessed using a self-administered questionnaire. RESULTS: For 196 subjects, MARI varied by type of adverse effect, level of pain relief, and baseline risk. Mean MARI ranged from 3% to 5% for heart attack/stroke, 5% to 8% for stomach bleed, 13% to 21% for hypertension, 22% to 33% for fluid retention, and 23% to 35% for dyspepsia. Age, gender, education, physical and mental health, pain, disability, and locus of control were not associated with MARI. CONCLUSION:Participants varied widely in the level of risk they would accept, but their clinical, sociodemographic, and psychological characteristics did not explain this variation. These observations are important for the development of practice guidelines for physicians and patients' decision aids that can foster individualized, evidence-based yet preference-sensitive care for patients with OA.
Authors: Sofia de Achaval; Liana Fraenkel; Robert J Volk; Vanessa Cox; Maria E Suarez-Almazor Journal: Arthritis Care Res (Hoboken) Date: 2012-02 Impact factor: 4.794
Authors: Jennifer E Flythe; Derek Forfang; Nieltje Gedney; David M White; Caroline Wilkie; Kerri L Cavanaugh; Raymond C Harris; Mark Unruh; Grace Squillaci; Melissa West; Carol Mansfield; Cindy S Soloe; Katherine Treiman; Dallas Wood; Frank P Hurst; Carolyn Y Neuland; Anindita Saha; Murray Sheldon; Michelle E Tarver Journal: Kidney360 Date: 2022-05-05
Authors: Holly L Peay; Ryan Fischer; Brennan Mange; Ryan S Paquin; Edward C Smith; Alesia Sadosky; Leo Russo; Valeria Ricotti; Colin Rensch; Carl Morris; Amy Strong Martin; Annie Ganot; Katherine Beaverson; Carol Mansfield Journal: Mol Genet Genomic Med Date: 2021-03-23 Impact factor: 2.183