2019 Volume 31 Issue 2 Pages 104-111
Purpose: An interview-based study was conducted to clarify aging-associated attitude changes in elderly patients with rheumatoid arthritis（RA）and determine divergence between patients and rheumatologists in private practice（RP）in Japan.
Methods: Overall, 20 Japanese rheumatologists and their randomly chosen 1,066 patients completed a 10-item questionnaire, which configured generation, dwelling area, job status/style of RPs and patients, coping with extra-articular comorbidities, activities of daily living decline, cognitive decline, needing admission, bedridden status, end-of-life care, and identical medical alliance image. All questions were matched between patients and rheumatologists, and mismatches were statistically evaluated with chi square test.
Results: Overall, >64% of patients with RA desired that their rheumatologist, similar to general physicians, should not only treat RA but also its associated comorbidities and >90% of RPs did cope with it. Most patients relied on their attending RPs and desired to receive care during admissions. Answers that demonstrated partial mismatch between patients with RA and their attending RPs were concerning end-of-life care. In elderly patients, the image at the end-of-life is concretely configured（p < 0.05）. In >90% of elderly patients with RA who have a detailed image for death and desired end-of-life care, only ５ of 20 rheumatologists were prepared for providing the care（p < 0.05）.
Conclusions: Continued care up to and including death is needed in Japanese RPs such as general physicians. Japanese rheumatologists need to cope with aging problems of patients honestly.
