Utilising Adaptive Choice-Based Conjoint Approach to Facilitate Shared Decision-Making in Osteoarthritis Management: A Patient Perception Study.

Abstract

Objective: This study examines the application of the adaptive choice-based conjoint (ACBC) method to facilitate the shared decision-making (SDM) process for osteoarthritis (OA) treatment.

Methods: The study recruited adult OA patients attending the rheumatology/orthopaedics clinics in a local urban hospital in Abu Dhabi, United Arab Emirates (UAE). Participants completed a questionnaire regarding who influences their decision in selecting OA medication, followed by an ACBC questionnaire about OA medication preferences and a questionnaire about the potential contribution of ACBC to the SDM process. A univariate analysis was used to investigate the relationships between participant variables and factors that influence their decision-making processes. The chi-squared, Fisher's exact, Cramer's V coefficient test and multivariable logistic regression analysis were utilised. The primary outcome investigates the contribution of the ACBC method to the SDM process for OA treatment. Secondary outcomes measure the association between patient demographics and variables related to the SDM process and ACBC questionnaire.

Results: Five hundred patients participated in this study, with a response rate (RR) of 100%. Most study participants were 60-69 years old (34.8%), females (78.8%), and UAE nationals (90.4%). Patients' opinions and online/paper information influencing their decision in selecting OA medication had a statistically significant association with age, gender, education, and employment (P=0.001 - 0.039). Employment status showed the strongest association (φc=0.170) with being independent in making the decision about OA medications, while education levels showed the strongest association (φc=0.24) with decisions impacted by online/paper information. The results of the multivariable logistic analysis showed that the only statistically significant variable for online/paper information that influenced the decision in selecting OA medication was education level (p=0.003). Most participants agreed or strongly agreed that the ACBC predicted their preferences for OA treatment (96.8%), the questionnaire may help doctors understand patients' preferences (93%) and recommended the use of ACBC tool doctors' clinics to aid the SDM process (92.8%) between patients and their physicians.

Conclusions: ACBC approach can facilitate doctors' understanding of patients' preferences and aid the SDM process. Most OA patients are independent or influenced by their physician when making decisions about OA medication. Higher education and employment among OA patients are associated with a better involvement in the SDM process for available treatment.