Japanese Rheumatoid

Since the 1990s, shared decision-making (SDM) as a component of personalized patient care; has attracted a great deal of interest, in particular in North America and Europe. The introduction of informed consent rules, new demands regarding consumer advocacy and informed choice, “doctor shopping,” and advances in treatment options have together led to the transition of SDM from the acute care setting only to the chronic care setting as well.

Moreover, there is a treatment paradigm change; one that moves away from the more traditional “paternalistic” approach and toward joint doctor-patient discussions of treatment options. It has been shown that both patient satisfaction and treatment outcomes are with trust; cultural competence, and SDM. However, despite the efforts of doctors to incorporate SDM into their treatment approach; research has revealed a discrepancy between doctors’ perception of patients’ SDM needs and patients’ preferences.

The common comorbidity

There is growing evidence that depression is a common comorbidity among RA patients and that it is with a significant burden of illness. While the prevalence of depression varies across studies; it was estimated to be as high as 42% among RA patients. In our sample; 35% of patients identified as suffering from either mild (24%) or severe (11%) depression. It has also been shown that depression in Japan often remains undiagnosed.

They found that while 89% of the patients in our Japanese sample of RA patients reported satisfied with their current treatment, only 72% of those patients with severe depression satisfied. This difference suggests that addressing this comorbidity explicitly might enhance treatment satisfaction and thereby clinical outcomes.

Treatment preference fit to an important component of satisfaction for all patients responding to the survey questions. This finding confirms the expectation-confirmation theory, which was initially developing in consumer psychology to model consumer satisfaction as a function of expectations, perceived performance, and disconfirmation of beliefs. This model was to the healthcare setting by Alden et al.

Generalizability of consumer behavior

To demonstrate that patient satisfaction is driven by the extent to which clinic performance meets or exceeds prior expectations. The strong impact of our preference fit index on patient satisfaction nicely shows the generalizability of consumer behavior theory even for a country with a different cultural context. Shared decision-making has shown to benefit treatment outcomes by increasing adherence to the treatment regimen.

It also reduces “doctor hopping,” which is a growing phenomenon among chronic care patients; also in countries with good general healthcare programs. At the same time, specialty physicians often misread the SDM preferences of patients who suffer from depression. They have strong evidence that the fit in SDM preferences is lower for depressed patients.

The patient’s mental health is a critical component of SDM. Especially in countries where depression remains undertreated, RA specialty physicians may improve treatment outcomes by taking mental health into account in the treatment regimen. Improving SDM preference matching and including a drug regimen that addresses both RA and depression may also bring benefits through higher patient satisfaction.