Background/Purpose: Current guidelines for the treatment of rheumatoid arthritis (RA) underscore the importance of an early and targeted approach to control inflammation. We describe initial experiences in recruiting RA patients (target n=300) from clinic sites versus an online patient support network into a randomized trial comparing the effectiveness of two educational interventions designed to enhance informed decision-making.

Methods: Participants are recruited from four clinic sites and CreakyJoints, an online patient support network. Eligibility criteria include: physician-diagnosed RA, moderate/high disease activity per the RAPID3, eligible for treatment escalation per provider, and internet access. Two interventions are being evaluated: (1) DrugFactsBoxes, which provide quantitative information concerning potential medication benefits and harms, and (2) Gist Reasoning Training, which is designed to help patients develop the skills needed to process complex information (e.g., the nature of scientific uncertainty). Data are collected by telephone interviews and on-line questionnaires. Because data collection is currently underway, this presentation focuses on the results of recruitment efforts.

Results: CreakyJoints sent 3,094 emails to their online community from January through March 2017, inviting members to participate in the study. Of these, 979 (31.6%) emaiIs were opened and 269 (8.6%) people clicked a link in the email taking them to the study website. A total of 156 (58.0%) of the CreakyJoints members who visited the website emailed study staff expressing interest in participating,139 met study eligibility criteria, and 96 have completed baseline data collection. During this same time period, 34 participants were recruited via the four clinic sites and completed baseline data collection. Compared to participants recruited via clinic sites, those recruited via CreakyJoints are less likely to be African-American (7% versus 22%, p = 0.02) or Hispanic (3% versus 14%, p = 0.02) and have greater RA knowledge (Means: 85.1 versus 75.4, p <0.0001) and higher health literacy as assessed by the Newest Vital Sign (Means: 83.5 versus 73.7, p = 0.02). Participants recruited via CreakyJoints, versus clinic sites, were equally likely to be women (95% versus 91%, p=0.46), have completed college (55% versus 61%, p=0.59), and be using a DMARD (12% versus 6%, p=0.28).

Conclusion: Recruitment from an online support community is feasible and efficient. Online participants may differ from clinic participants in some sociodemographic characteristics. Better understanding of these differences is needed to improve the generalizability of results generated from online communities and clinic sites to maximize the external validity of research findings.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-trial-testing-strategies-to-enhance-patient-understanding-of-drug-information-experience-recruiting-subjects-through-an-online-patient-community/