Peer to Peer Mentoring for Individuals with Early Inflammatory Arthritis: Feasibility Pilot

Mary J. Bell¹, Paula Veinot², Gayathri Embuldeniya², Joyce Nyhof-Young³, Joanna Sale⁴, Joan Sargeant⁵, Peter Tugwell⁶, Sydney Brooks⁷, Susan Ross⁷, Ruth Tonon⁷, Sharron Sandhu², Dawn Richards⁸, Jennifer Boyle⁷, Kerry Knickle⁹, Nicky Britten¹⁰, Emma Bell², Fiona Webster¹¹ and Mary Cox-Dublanski¹², ¹Division of Rheumatology, Sunnybrook Health Sciences Centre and University of Toronto, Toronto, ON, Canada, ²Rheumatology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada, ³University Health Network, University of Toronto, Toronto, ON, Canada, ⁴Healthy Policy, Management, and Evaluation, University of Toronto, St. Michael's Hospital, Toronto, ON, Canada, ⁵Dalhousie University, Halifax, NS, Canada, ⁶Institute of Population Health, Center For Global Health, University of Ottawa, Ottawa General Hospital, Ottawa, ON, Canada, ⁷The Arthritis Society, Ontario Division, Toronto, ON, Canada, ⁸Canadian Arthritis Network Consumer Advisory Council, Toronto, ON, Canada, ⁹University of Toronto, Toronto, ON, Canada, ¹⁰University of Exeter, Exeter, United Kingdom, ¹¹Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada, ¹²St. Mary's General Hospital, Kitchener, ON, Canada

Meeting: 2012 ACR/ARHP Annual Meeting

Keywords: Inflammatory arthritis and rheumatoid arthritis (RA)

Session Information

Title: Rheumatoid Arthritis - Clinical Aspects III: Infections/Risk Factors for Incident Rheumatoid Arthritis/Metrology/Classification/Biomarkers/Predictors of Rheumatolid Arthritis Activity & Severity

Session Type: Abstract Submissions (ACR)

Background/Purpose:

The goal of this research is to examine the potential benefit of early peer support to improve the health and quality of life of individuals with early inflammatory arthritis (EIA). This poster presents preliminary findings of a pilot study, as part of a complex healthcare intervention, to assess acceptability and feasibility of a peer support intervention for individuals with EIA.

Methods:

Qualitative and quantitative methods were used to evaluate a feasibility pilot of a peer mentoring intervention for individuals with EIA. Individuals with IA (diagnosed at least 2 years and managing well) were recruited through a rheumatology clinic, The Arthritis Society, and research team to be trained as peer mentors A peer mentor training model was developed consisting of 18 hours of didactic and interactive sessions over 4 non-consecutive days. Individuals with EIA (mentees; disease duration 6-52 weeks) were recruited through 2 rheumatology clinics. Trained peer mentors were paired with an individual with EIA to provide one-on-one support (face-to-face or telephone) up to once a week over a 12 week period. Peer mentor self-efficacy was assessed at baseline, immediate post-training, immediate post-peer mentoring program and 3-months follow-up. Mentees were assessed at baseline, immediate post-program and 3-months follow-up re: disease modifying anti-rheumatic drugs (DMARDs)/biologic treatment use, self-efficacy, self-management, health-related quality of life, anxiety, coping-efficacy, social support and disease activity. Results were examined using descriptive statistics, and effect sizes were calculated to determine clinically important changes (changes >0.3 considered important). One-on-one interviews with participants were also conducted to examine acceptability and feasibility of study procedures and outcome measures and to gain perspectives on the value of peer support. Key themes were identified through constant comparison.

Results:

Nine pairs participated. The training was well-received by peer mentors. Peer mentors’ self-efficacy increased significantly after training completion. Mentees experienced improvement in overall arthritis impact on life, coping, and social support (effect size>0.3). Mentees perceived emotional, informational, appraisal, and instrumental support, while mentors themselves reported benefits (e.g., new self-management techniques, lifestyle changes), and learned from mentees’ fortitude and self-management skills. Participants’ experience of peer support was informed by the unique relationship they forged with their peer partner. All participants were unequivocal about the need for peer support for the newly diagnosed.

Conclusion:

Early peer support is proposed as a way to augment current care in rheumatology. The intervention was well-received. The training process, peer support program, and outcome measurements were demonstrated to be feasible with modifications. This intervention has been expanded to a small pilot RCT study to demonstrate effectiveness of peer support in EIA management.

Disclosure:

M. J. Bell,
None;

P. Veinot,

Consultant,

G. Embuldeniya,

Sunnybrook Health Sciences Centre,

J. Nyhof-Young,
None;

J. Sale,
None;

J. Sargeant,
None;

P. Tugwell,

UCB, Chelsea,

BMS,

Actellion, Alderbio, Amgen, Ardea Biosciences, Astra Zeneca, Bristol Myers Squibb,

Jazz Pharmaceuticals, Merck, Novartis, Novo Nordisk, Pfizer,Regeneron, Savient, Takeda ,

EliLilly/Boehringer-Ingelheim, Genentech, Genzyme, Celgene, Centocor, Cypress/Forest,

Abbott, Roche, Schering Plough/Merck, UCB, BMS ,

S. Brooks,

The Arthritis Society,

S. Ross,
None;

R. Tonon,
None;

S. Sandhu,
None;

D. Richards,
None;

J. Boyle,
None;

K. Knickle,
None;

N. Britten,
None;

E. Bell,

Consultant,

F. Webster,
None;

M. Cox-Dublanski,
None.

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