University of Twente Student Theses
Key factors for pediatric rheumatologists in deciding whether to prescribe a new medicine in patients with Juvenile Idiopathic Arthritis
Sloof, Michelle (2023) Key factors for pediatric rheumatologists in deciding whether to prescribe a new medicine in patients with Juvenile Idiopathic Arthritis.
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| Full Text Status: | Access to this publication is restricted |
| Embargo date: | 1 June 2025 |
| Abstract: | Background: In the past decades, the number of therapeutic options to treat Juvenile Idiopathic Arthritis (JIA) has grown substantially. This increases the complexity of decisions which treatment to prescribe, and at what point in time. As a consequence, pediatric rheumatologists often face difficult decisions in which they have to outweigh the potential benefits of improving disease control against the potential drawbacks of unknown long term impacts and high costs of new medicines. Objective: The goal of this survey is to investigate which factors influence the decision of pediatric rheumatologists regarding whether or not to prescribe new medication to patients with JIA. In the current study, ‘new medication’ is defined as medication that was approved by the European Medicines Agency less than two years ago. Examples of such new medicines are tofacitinib and secukinumab. Methodology: This research consisted of two parts. In the first part, a scoping research was conducted to create a generic list of factors that can influence the clinician’s decision to prescribe a new medicine. For the second part of the research, a survey was created to identify which factors are important in the decision-making process of a new medicine for JIA. The survey consisted of three parts. In the first part the respondent was presented with a list of potential factors that may influence their decision in prescribing a new medicine to a JIA patient. The respondent was asked to indicate the importance of each factor ranging from ‘not important at all’ to ‘extremely important’ on a seven-point Likert scale. In the second part of the survey, the respondent was asked to select a top 5 of all these factors, and indicate whether these factors are a barrier or facilitator of prescribing a new medicine. Next, the five factors were ranked in order of importance. In the last part, background information about the respondent was collected. All analyses were conducted using SPSS. Results: In total, nine respondents filled out the questionnaire. The most consistently important factors were ‘(in)effectiveness of the current treatment’ and ‘evidence from clinical trials into the new medicine, as reported in literature or presented at JIA-related conferences’. Conclusion: This research shows that the factors ‘(in)effectiveness of the current treatment’ and ‘evidence from clinical trials into the new medicine, as reported in literature or presented at JIA-related conferences’ are the most important factors for JIA clinicians in deciding whether to prescribe a new medicine. However, the number of respondents was low, which limits the robustness of the results. More research in different countries is needed to increase the generalizability of this research. |
| Item Type: | Essay (Master) |
| Clients: | Wilhelmina Children's Hospital, Utrecht |
| Faculty: | TNW: Science and Technology |
| Programme: | Health Sciences MSc (66851) |
| Link to this item: | https://purl.utwente.nl/essays/95102 |
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