ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2022
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2084

Effects of a Web-Based Patient Decision Aid on Biologics for Rheumatoid Arthritis: A Proof-of-Concept Study

Linda Li1, Chris Shaw2, Diane Lacaille1, Elaine Yacyshyn3, C. Allyson Jones4, Paul Adam5, Cheryl Koehn6, Alison Hoens7, Jasmina Geldman8, Charles Goldsmith9, Eric C. Sayre8 and Nick Bansback10, 1Rheumatology, Arthritis Research Canada, Richmond, BC, Canada, 2School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada, 3University of Alberta, Edmonton, AB, Canada, 4Physical Therapy, University of Alberta, Edmonton, AB, Canada, 5Mary Pack Arthritis Program, Vancouver, BC, Canada, 6Arthritis Consumer Experts, Vancouver, BC, Canada, 7Dept of Physical Therapy, University of British Columbia, Vancouver, BC, Canada, 8Arthritis Research Canada, Richmond, BC, Canada, 9Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada, 10School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: Education, patient, patient health, patient preferences, rheumatoid arthritis (RA) and shared dicision making

  • Tweet
  • Email
  • Print
Session Information

Date: Monday, November 14, 2016

Session Title: ARHP IV: Clinical Practice, Patient Care and Health Services

Session Type: ARHP Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose : Under the treat-to-target approach for patients with rheumatoid arthritis (RA), a biologic agent is considered when the target is not met despite trying disease-modifying anti-rheumatic drugs. However, patients sometimes struggle with the decision to use these medications due to the potential side effects. We have developed a user-friendly decision aid, ANSWER-2, for patients who are considering biologic and small molecule agents. Patient decision aids are designed to present the potential benefits and harm of treatment options and clarify individuals’ preferences. A main feature of ANSWER-2 is the trade-off exercise designed to help patients consider value-sensitive options (e.g., the mode and frequency of medication administration). We aimed to assess the extent to which ANSWER-2reduces patient’s decisional conflict, and improves their medication-related knowledge and self-management capacity.

Methods: We used a pre-post study design. Participants were recruited from rheumatologists’ clinics, patient groups and social networking sites (e.g., Facebook). Individuals were eligible if they: 1) had a physician diagnosis of RA, 2) had been recommended to start/switch to a new biologic or small molecule agent, and 3) had internet access. Access to ANSWER-2 was provided immediately after enrollment. Participants completed outcome measures before and within 2 days after using ANSWER-2. They included: 1) Decisional Conflict Scale (DCS; 0-100, scores < 25 are associated with follow-through with decisions), 2) Partners in Health Scale (PIHS; 0-88, lower = better), and 3) Medication Education Impact Questionnaire (MeiQ; 6 subscales, higher score = better). Paired t-test or Wilcoxon signed-rank test was used to assess differences pre and post intervention.

Results: 50 participants were enrolled in November 2014 – December 2015. The majority were women (n = 40) with a mean age of 49.6 years (SD: 12.2). 64% (n = 32) attended/completed university. The median disease duration was 5 years (Q1; Q3: 2; 10). The mean DCS was 45.9 (SD: 25.1) pre-intervention and 25.1 (SD: 21.8) post-intervention (change: -21.2, 95% CI: -28.1, -14.4; p < 0.001). Before using ANSWER-2, 20% of participants scored < 25, compared to 52% after the intervention. Similar results were observed in the PIHS (pre: 25.3, SD: 14.8; post: 20.4, SD: 13.0; change: -3.7, 95% CI: -6.3, -1.0; p= 0.009). Findings from the MeiQ were mixed, with statistically significant differences found in the self-management sub-scales (Table 1).

Table 1: Results of MeiQ Subscales
MeiQ subscale (maximum possible score)

Before (SD)

After (SD)

Difference (95% CI)

p

Information Quality (30)

21.9 (5.5)

22.4 (5.0)

0.3 (-0.6, 1.3)

0.490

Active Communication (24)

18.8 (4.6)

19.5 (3.7)

0.7 (-0.1, 1.4)

0.086

Coming to Terms with Diagnosis & Treatment (24)

19.4 (3.0)

19.7 (2.9)

0.3 (-0.3, 1.0)

0.299

Self-management Ability (36)

26.7 (5.3)

28.0 (4.9)

1.3 (0.0, 2.5)

0.048

Self-management Role & Responsibility (36)

31.8 (3.3)

32.6 (2.8)

0.9 (0.2, 1.6)

0.012

Self-management Support (24)

17.5 (4.4)

18.9 (3.2)

1.1 (0.2, 2.0)

0.019

Conclusion: Patients’ decisional conflict and self-management capacity improved after using ANSWER-2. Our results show similar changes to other studies evaluating patient decision aids in chronic diseases, including RA1. Future research comparing ANSWER-2with education material on biologics will provide further insight into the value of patient decision aids in RA management. (1) Li et al. Arthritis Care Res 66:1472-81, 2014.


Disclosure: L. Li, None; C. Shaw, None; D. Lacaille, None; E. Yacyshyn, None; C. A. Jones, None; P. Adam, None; C. Koehn, None; A. Hoens, None; J. Geldman, None; C. Goldsmith, I have been paid to do statistical consulting on this project, including randomization and overseeing the statistical analysest, 5; E. C. Sayre, None; N. Bansback, None.

To cite this abstract in AMA style:

Li L, Shaw C, Lacaille D, Yacyshyn E, Jones CA, Adam P, Koehn C, Hoens A, Geldman J, Goldsmith C, Sayre EC, Bansback N. Effects of a Web-Based Patient Decision Aid on Biologics for Rheumatoid Arthritis: A Proof-of-Concept Study [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/effects-of-a-web-based-patient-decision-aid-on-biologics-for-rheumatoid-arthritis-a-proof-of-concept-study/. Accessed January 28, 2023.
  • Tweet
  • Email
  • Print

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/effects-of-a-web-based-patient-decision-aid-on-biologics-for-rheumatoid-arthritis-a-proof-of-concept-study/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2023 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
  • Cookie Preferences