Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Challenges to Achieving Optimal Disease Control in RA

Perceived medication risk aversion, suboptimal treatment adherence, and suboptimal patient-physician communication are among the patient- and rheumatologist-reported barriers to achieving optimal disease control in rheumatoid arthritis, a new study found. RA patients and rheumatologists from the Consortium of Rheumatology Researchers of North American (Corrona) registry were invited to participate in nominal groups (NGs). Among the findings:

  • 4 NGs with 37 RA patients identified patient-barriers to achieving control of RA activity that were classified into 17 themes. 3 NGs with 25 rheumatologists identified barriers that were classified into 11 themes.
  • Financial aspects of RA care ranked first for both types of NGs, while medication risk aversion ranked second and third among the physician- and patient-NG-generated barriers, respectively.
  • Among the 450 patients surveyed, 77% considered RA a top-health priority and 51% reported being aware of the treat-to-target strategy for RA care.
  • The 3 most important patient-perceived challenges to achieving disease control were RA prognosis uncertainty, medication risk aversion, and the financial burden associated with RA care.


Owensby JK, Chen L, O’Beirne R, et al. Patient- and rheumatologist- perspectives regarding challenges to achieving optimal disease control in rheumatoid arthritis. [Published online ahead of print April 22, 2019]. Arthritis Care Res. doi: 10.1002/acr.23907.