Session Information
Session Type: Poster Session A
Session Time: 10:30AM-12:30PM
Background/Purpose: To implement a self-administered patient decision-aid (PtDA) for lupus in outpatient clinics, assess its reach/penetration within each clinic, and examine patient outcomes
Methods: An effective computerized lupus PtDA was provided through a touchscreen tablet in clinics, a weblink, or as smartphone application, in 15 rheumatology outpatient clinics. We examined penetration/reach in the clinic. Secondary outcomes at baseline, 12- and 24-month follow-up based on validated surveys included: (1) Patient decisional conflict (score range 0-100; lower score is better); (2) shared decision-making (SDM) with Control Preferences Scale (CPS) that assesses the concordance between patient’s preferred and actual role in managing lupus was assessed with 2-item (percent agreement; range, 0-100%; higher % agreement indicating better SDM); (3) patient involvement in SDM on 3-item CollaboRATE scale (score range 0-27; higher score indicating better involvement and understanding); (4) patient-physician communication using Inter-personal Processes of Care Short Form (IPC-SF; 18-item; score range 18-90; higher scores indicating better care process); and (5) patient satisfaction using 1-item (score range 1-5, higher scores indicating higher satisfaction).
Results: Among 15 geographically diverse U.S. rheumatology clinics, 1,773 patients viewed the lupus PtDA during regular clinic visits. The penetration/reach (primary outcome) ranged from 9% to 60%. We found that the total number of providers in the clinic was positively associated with higher clinic penetration.
Post-PtDA view patient outcomes (n=1,773) were good-excellent at baseline: (1) Low decision conflict scale (DCS) score of 19.5 (range 0-100;); (2) 82.4% matched with regards to their preferred role to play versus the actual role played in treatment decision-making; (3) patient involvement in SDM, CollaboRATE score was 25.1 (SD, 4.2; range 0-27); (4) patient-physician communication process score, 82.3 (SD, 9; range 18-90); (5) 86.2% were satisfied with the ease of use. Each score persisted at two follow-up visits.
Conclusion: We implemented a patient lupus PtDA dissemination for SDM in 15 geographically diverse sites with varied success rates. Patients reported favorable outcomes using the lupus PtDA. The lupus PtDA app (ManageMyLupus) is now freely available.
Funding:
Research reported in this work was funded through a Patient-Centered Outcomes Research Institute (PCORI) Award (SDM-2017C2-8224). The statements in this publication are solely the responsibility of the authors and do not necessarily represent the views of PCORI, its Board of Governors, or the Methodology Committee.
To cite this abstract in AMA style:
Singh J, Hearld L, Chatham W, Narain S, Annapureddy N, Kamen D, Trotter K, Majithia v, Aouhab Z, Venuturupalli S, Wallace D, Ramsey-Goldman r, Kim A, McMahon M, Lim S, Bhairavarasu K, Meara A, Kalunian K, Lee Ching C. Patient Outcomes During the Implementation of a Patient Decision-Aid for a Diverse Population of Systemic Lupus Erythematosus: A Study in 15 U.S. Rheumatology Clinics [abstract]. Arthritis Rheumatol. 2024; 76 (suppl 9). https://acrabstracts.org/abstract/patient-outcomes-during-the-implementation-of-a-patient-decision-aid-for-a-diverse-population-of-systemic-lupus-erythematosus-a-study-in-15-u-s-rheumatology-clinics/. Accessed .« Back to ACR Convergence 2024
ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-outcomes-during-the-implementation-of-a-patient-decision-aid-for-a-diverse-population-of-systemic-lupus-erythematosus-a-study-in-15-u-s-rheumatology-clinics/