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Are health care professionals’ implicit and explicit attitudes toward conventional disease‐modifying antirheumatic drugs associated with those of their patients?

Heuckelum, M. van, Hebing, R.C.F., Vandeberg, L., Linn, A.J., Flendrie, M., Nurmohamed, M.T., Dulmen, S. van, Ende, C.H.M. van den, Bemt, B.J.F. van den. Are health care professionals’ implicit and explicit attitudes toward conventional disease‐modifying antirheumatic drugs associated with those of their patients? Arthritis Care and Research: 2021, 73(3), p. 364-373
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Objectives
Up to now, it is unknown if healthcare professional (HCP)'s attitudes and beliefs might affect attitudes, beliefs and medication-taking behaviour of patients with rheumatoid arthritis (RA). This study aims to 1) examine HCPs' attitudes, health-related associations (both implicit and explicit) and beliefs about conventional DMARDs, and 2) to assess whether these are associated with those of their patients, with patient's medication-taking behaviour and disease activity.

Methods
HCPs were recruited in two rheumatology specialized centers across the Netherlands followed by patient recruitment. In this observational study, implicit outcomes were measured with Single Category Implicit Association Tests, whereas explicit outcomes were measured with a bipolar evaluative adjective scale and the Beliefs about Medicines Questionnaire Specific. Spearman's rank correlations were used to describe correlations between implicit and explicit measures of HCPs. Multilevel mixed effects linear models were used to examine the association of HCP-related characteristics, including HCP's implicit and explicit outcomes, with those of their patients, and medication-taking behaviour and disease activity.

Results
Of the 1659 initially-invited patients, 254 patients with RA (mean age: 62.8yrs, mean disease duration: 11.8yrs, 68.1% female) treated by 26 different HCPs agreed to participate in this study. HCP's characteristics, attitudes, health-related associations and beliefs about medicines were not significantly associated with those of their patients, nor with medication-taking behaviour or disease activity scores.

Conclusion
This study revealed that HCP's attitudes and health-related associations (both implicit and explicit) together with beliefs, were not significantly associated with attitudes, beliefs, medication-taking behaviour, and disease activity of patients with RA.