Background/Purpose: Patient decision aids are designed to present the potential benefits and harm of treatment options, clarify individuals’ preferences, and guide discussion at a clinic visit. The majority of decision aids on arthritis treatments are in printed formats. Although informative, they tend to be less engaging for users. We applied the concept of edutainment (i.e., education that engages through entertainment) to develop a web-based decision aid called ANSWER. Designed for patients with rheumatoid arthritis (RA), ANSWER presents information on methotrexate (MTX) in print, voice recording, and animated stories created with Adobe Photoshop. The current study aims to assess the extent to which ANSWER reduces patient’s decisional conflict, and improves their medication knowledge and skills of being ‘effective healthcare consumers’.
Methods: We used a pre-post study design. Participants were recruited from rheumatologists’ clinics, patient groups and social networking sites (Facebook, Twitter, Craigslist, Kijiji). Eligible participants were those who: 1) had a physician diagnosis of RA, 2) had been prescribed MTX but were unsure about starting it, 3) had access to the internet. Password access to the ANSWER was provided immediately after enrollment. Participants completed a questionnaire before and within 48 hours after using the ANSWER. Outcome measures included: 1) Decisional Conflict Scale (DCS, primary outcome; 0-100, scores <25 are associated with follow-through with decisions), 2) MTX in RA Knowledge Test (MiRAK; 0-60, higher=better), and 3) Effective Consumer Scale (EC-17; 0-100, higher=better). Paired t-test was used to assess differences before and after the intervention.
Results: 30 participants were recruited between November 2010 and April 2012. The majority were women (n=23, 76.7%) with a mean age of 54.90 years (SD=14.91). 73.3% (n=22) attended/graduated from university. The median disease duration was 1 year (IRQ=0.3; 5.0), and the mean Health Assessment Questionnaire score was 1.16 (SD=0.68). The mean DCS was 49.50 (SD=23.17) pre-intervention and 21.83 (SD=24.12) post-intervention (change= -27.67, 95% CI= -15.44, -39.89; p<0.001). Before using the ANSWER, 13.3% of participants scored <25, compared to 70% after the intervention. Similar results were observed in MiRAK (pre: 30.62, SD=9.26; post: 41.67, SD=6.81; change: 11.03, 95% CI=6.73, 15.34; p<0.001), but not in EC-17 (pre: 68.24, SD=12.46; post: 72.94, SD=12.74; change: 4.71; 95% CI= -1.81, 11.22; p=0.15). After using the ANSWER, 20 participants (66.6%) were able to make a decision (14 would take MTX, 6 would decline MTX and talk to their doctor about other treatment options). 10 participants (33.3%) remained unsure about their preferred choice.
Conclusion: Patients’ decisional conflict and MTX knowledge improved after using the ANSWER. Our results show similar changes to other studies evaluating decision aids in chronic diseases. The lack of a statistically significant change in the EC-17 might reflect the fact that it takes time to develop effective consumer attributes, such as how to find resources. Further research into the application of edutainment in developing patient decision aids and education programs is warranted.
Disclosure:
L. C. Li,
None;
P. M. Adam,
None;
C. L. Backman,
None;
S. Brooks,
None;
G. A. Ellert,
None;
A. Jones,
None;
O. Kamensek,
None;
C. Koehn,
None;
D. Lacaille,
None;
C. Maloney,
None;
A. F. Townsend,
None;
E. Yacyshyn,
None;
C. Yousefi,
None;
D. Stacey,
None.
« Back to ACR/ARHP Annual Meeting 2012
ACR Meeting Abstracts - https://acrabstracts.org/abstract/a-proof-of-concept-study-of-an-animated-web-based-methotrexate-decision-aid-for-patients-with-rheumatoid-arthritis/