Background:Shared decision-making (SDM) impacts medical and patient-reported outcomes.Objective:The study compared perceptions of SDM between Mexican patients with rheumatic diseases (RMDs) and their attending rheumatologists, identified some factors associated with adequate SDM, and examined the relationship between patient perceptions of SDM and dignity.Patients and Methods:This cross-sectional study was performed between September 2024 and April 2025. Consecutive patients with RMDs completed validated Spanish versions of SDM (SDM-9-Q) and perceived dignity (PDI-Mx). SDM was assessed in the attending rheumatologists with the SDM-Doc-Q. Adequate SDM was defined as a score of >= 72.6 on the SDM-Q-9. Multivariate regression analysis was used.Results:Data from 170 patient-physician encounters were analyzed. Scores of the SDM-9-Q and SDM-Q-Doc showed no differences. However, patients scored higher on items pertaining to the need to decide about the treatment, available treatment options, and related information than doctors did. There were 113 patients (66.5%) with adequate SDM. The duration of underlying RMD [Exp (B): 1.046; 95% CI: 1.008-1.085, p = 0.017] and treatment modifications during encounters [Exp (B): 2.099; 95% CI: 1.073-4.105, p = 0.030] were associated with this outcome. Spearman rho between SDM-9-Q score, SDM-9-Q individual items scores, and the PDI-Mx score was inverse and not significant, but for item 2, related to autonomy principle: rho = -0.160, p = 0.037.Conclusions:Overall perception of SDM was similar between patients with RMDs and their rheumatologists. RMD-related characteristics were associated with patient' perceptions of adequate SDM, observed in two-thirds of the participants. A weak correlation was observed between patient's autonomy ideal-related to the SDM process and their perceived dignity.
Objectives:Ankylosing spondylitis (AS) is an autoimmune disorder marked by chronic inflammation that may accelerate atherosclerosis and increase ischemic heart disease (IHD) risk. This study assessed the association between AS and IHD using nationwide data.Methods:A retrospective historical cohort study was performed using Korean National Health Insurance Service data (2012-2023). AS was defined by the ICD-10 code M45 and the rare disease code V140. After a 3-year washout, IHD was defined as >= 2 visits with codes I20 to I25. Propensity score-matched controls (1:10) were selected, and proportional hazards models were applied.Results:A total of 2869 patients with AS and 28,690 matched controls were followed for a mean of 4.2 years. IHD occurred in 7.08% of patients with AS and 5.05% of controls. The incidence rate ratio (IRR) was 1.42 (95% CI: 1.23-1.65). Subgroup analyses revealed a higher risk among current smokers (IRR, 1.85). The risk increased with longer follow-up periods, especially in older men.Conclusions:AS was significantly associated with elevated IHD risk, particularly among smokers and low-income groups. Early cardiovascular risk management is warranted.
