Background/Purpose: A successful Treat-to-Target approach to managing Rheumatoid Arthritis (RA) requires shared decision making with patients and healthcare providers. However patients may not have the education they need around the time of a new diagnosis to effectively partner with their providers in their RA care. Educational efforts must focus on interventions that are feasible, sustainable, and available to all RA patients as part of their rheumatology care. The purpose of this project was to implement a pragmatic nurse telephone education program for patients with recently diagnosed RA that promotes shared decision making and a treat-to-target approach.

Methods: This was a pilot project of newly diagnosed adult RA patients between November 2015 and December 2016. Rheumatology clinic nurses telephoned patients to offer disease education, targeting no more than 20 minutes per call. A shared decision making toolkit was mailed to the patient. Demographic data included patient age, sex, and zip code. RA-specific data included date of RA diagnosis, prescribed RA medications, routine assessment of patient index data 3 (RAPID3) scores if recorded, and date of next visit with the rheumatologist. Process measures included median call attempts, median call time, and a qualitative description of the free text notes. Outcome measures included the results from the satisfaction survey and proportion of patients who adhered to their next rheumatology visit. Data were analyzed descriptively and qualitatively.

Results: Twenty-six patients participated in the nurse calls. Most patients were female (65%), with a median age of 54 years (range 22-78). Median call length was 14.5 minutes with a range of 8-23 minutes. Qualitative notes indicate patients overwhelmingly support the nurse calls. Five patients returned the survey. All five patients indicated they would like calls from a nurse more than once per year. Twenty-three patients had follow-up visits at the time of this report. Sixteen patients (69.5%) were adherent to their follow-up visit.

Conclusion: This preliminary review successfully implemented an educational program that included a nurse-facilitated, RA-specific, telephone call and toolkit. The strength of our approach was designing our educational program with the goal of long-term sustainability and generalizability. This educational program could be a model for similar educational efforts by other rheumatology clinics.

ACR Meeting Abstracts - https://acrabstracts.org/abstract/nurse-telephone-education-for-promoting-a-treat-to-target-approach-in-recently-diagnosed-rheumatoid-arthritis-patients-a-preliminary-review/