Table 5.

Challenges in JIA treatment decisions

Sub-themes	Supporting quotations
Limited long-term data	“They want to know long-term and as these biologics are coming up quicker and quicker, we don’t have some of that data yet and so I think that’s challenging for me.” Clinician 4
	“…the unknowns about long-term use of these biologics … I think that factors in too, as far as any decision making that you have. That’s probably the biggest challenge.” Clinician 14
When to stop treatment	“You’re really worried about whether when you taper, whether there’s going to be a worsening disease, whether you’ll be able to use the same medications and whether it will be just as effective.” Clinician 13
	“One of the questions they always have also is when we stop this medicine which I think is harder to answer because I think we’re better in medicine, at starting medicines than stopping…” Clinician 11
Health System Challenges	“I think expenses are a big [challenge], how costly the medication is.” Clinician 9
	“…and trying to understand what would work best on them from a treatment standpoint as far as administering the medication, what their insurance may or may not pay for…” Clinician 3