Satisfaction with a Virtual Learning Collaborative Aimed at Implementing Treat to Target (TTT) in Rheumatoid Arthritis (RA)

Jack Ellrodt¹, Josef Smolen², Theodore Pincus³, Nancy Shadick¹, Jeffrey Katz¹, Leah Santacroce¹, Jacklyn Stratton¹, DH Solomon¹, Prem Chatpar⁴, Mary Stocks⁴, Breanna Mundell⁴, Christina Downey⁵, Karina Torralba⁶, Douglas White⁷, Meggan Baudek⁷, Steven Szlembarski⁷, Sharon Barnhart⁷, Jawad Bilal⁸, Albert Redford⁸, Dylan Lee⁸, Julia Buchfuhrer⁹, Helene Kramer⁸, C. Kent Kwoh¹⁰, Michel Villatoro-Villar⁸, Asha Patnaik¹¹, Edgardo Guzman¹¹, Rebecca Trachtman¹², John Tesser¹³, Dijana Music¹⁴, Lexi Mickey¹⁵, Mona Amin¹⁶, Jeffrey Potter¹⁷, Joshua Sundhar¹⁸, Jessica Sheingold¹⁹, Juan Schmukler²⁰, Diane Horowitz²¹, Hannah Gulko²¹, Robert Quinet²², Swathi Dhulipala²³, Ronak Patel²⁴, Chandana Keshavamurthy²⁵, Guiset Carvajal²⁶, Rhonda Dunn²⁷, Bharat Kumar²⁷, Aleksander Lenert²⁷, Hanna Zembrzuska²⁷, Matthew Gebre²⁸, Petar Lenert²⁹, Allen Anandarjah³⁰, Annie Yang³⁰, Linda Grinnell-Merrick³⁰, Shadefai Goldsmith³⁰, Jonna Zelie³⁰, Leanna Wise³¹, Nicole Zagelbaum Ward³² and Jeffrey Kaine³³, ¹Brigham and Women's Hospital, Boston, MA, ²University of Vienna, Vienna, Austria, ³Rush University Medical Center, Chicago, IL, ⁴Dr. Chatpar and Associates, LLC, Plainview, NY, ⁵Loma Linda University Medical Center, Redlands, CA, ⁶Division of Rheumatology, Department of Medicine, Loma Linda University Healthcare, Loma Linda, CA, ⁷Gundersen Health, La Crosse, WI, ⁸University of Arizona, Phoenix, AZ, ⁹University of Arizona, Pheonix, AZ, ¹⁰University of Arizona College of Medicine, Tuscon, AZ, ¹¹Stony Brook School of Medicine, Stony Brook, NY, ¹²Icahn School of Medicine at Mount Sinai, New York, NY, ¹³Arizona Arthritis & Rheumatology Associates, P.C., Phoenix, AZ, ¹⁴Arizona Arthritis and Rheumatology Associates, Glendale, AZ, ¹⁵Arthritis and Rheumatology Associates- Glendale, Glendale, AZ, ¹⁶Arthritis and Rheumatology Associates- Phoenix, Phoenix, AZ, ¹⁷Arthritis & Rheumatism Associates, Wheaton, MD, ¹⁸Arthritis Rheum & Back Disease Assoc., Voorhees, NJ, ¹⁹MedStar Georgetown University Hospital, Washington, DC, ²⁰Mount Sinai- Chicago, Chicago, IL, ²¹Northwell Health, Great Neck, NY, ²²Ochsner Health, River Ridge, LA, ²³Ochsner Clinic Foundation, River Ridge, LA, ²⁴Ochsner Health, Jefferson, LA, ²⁵Ochsner, New Orleans, LA, ²⁶University of Colorado, Colorado, CO, ²⁷University of Iowa, Iowa City, IA, ²⁸Loma Linda University Medical Center, Loma Linda, CA, ²⁹University of Iowa Medical School, Iowa City, IA, ³⁰University of Rochester, Rochester, NY, ³¹LAC+USC/Keck Medicine of USC, Pasadena, CA, ³²LAC+USC Medical Center, Los Angeles, CA, ³³Cullowhee, NC

Meeting: ACR Convergence 2021

Keywords: quality of care, rheumatoid arthritis

Session Information

Date: Monday, November 8, 2021

Title: Health Services Research Poster II: Care Models and Innovation (1061–1082)

Session Type: Poster Session C

Session Time: 8:30AM-10:30AM

Background/Purpose: Learning collaboratives (LC) have been used widely for quality improvement in healthcare, and a recent 9-month in person LC was found effective for improving treat to target (TTT) in RA (1). However, there is relatively little information about the experiences of participants in a virtual LC and little qualitative data or participant feedback on how this format can be improved.

Methods: During the COVID pandemic, we conducted a virtual LC with 18 rheumatology practices. The LC focused on implementing TTT in RA and included a virtual kick-off meeting (run over 5-6 hours) and monthly webinars. The kick-off meeting introduced topics and discussed plan-do-study-act (PDSA) cycles as a main tool for quality improvement. Practices prepared for the monthly webinars with 20-25 chart reviews and submission of PDSA cycles. At the end of the collaborative, leaders of each practice received an anonymous 12 question survey on site characteristics. All 45 participants, including site leads, received a separate anonymous survey focused on their experience in the LC. These questions asked participants to reflect on their participation and evaluate the LC. The following analyses describe the survey responses.

Results: All 18 active rheumatology practices and 35 of 45 participants (78%) responded to the site and individual surveys, respectively. Characteristics of the practices are shown in Table 1 and included multiple practice types, with 12 academic rheumatology practices, 2 academically affiliated practices, and 4 non-academic practices. The number of RA patients seen regularly at participating practices ranged widely from < 450 RA patients to > 1000. The number of participants in the LC at practices ranged from 1 to 8. As noted in Table 2, 63% of respondents indicated they attended 5 or 6 of the monthly webinars. 97% of respondents indicated they were somewhat or very active in monthly PDSA planning and approximately 77% of clinicians submitted chart reviews for 5 or 6 months of the collaborative. Table 2 shows that 94% of respondents indicated they were either somewhat or very satisfied with the LC, and 94% of respondents said they would recommend a similar LC to a colleague. Regarding LC format, 37% of respondents indicated they would prefer a virtual LC, and 51% indicated they would prefer a hybrid (virtual and in-person) model (Table 3). Respondents noted that they would be very interested in future LCs on a range of rheumatology-specific topics (Table 3), including improving management of glucocorticoid induced osteoporosis, cardiovascular risk factor management, reproductive health counseling, and laboratory monitoring for drugs and diseases.

Conclusion: Virtual multi-center LCs are feasible, and participants were very satisfied with the virtual format. Virtual LCs are highly valued by rheumatologists, trainees, and their practice staffs. Potential topics were identified for future LCs that could improve the quality of care delivered to rheumatology patients.

1. Solomon, D. H., et al. Implementation of Treat-to-Target in Rheumatoid Arthritis Through a Learning Collaborative: Results of a Randomized Controlled Trial. Arthritis Rheumatol 2017;69:1374-1380.

Disclosures: J. Ellrodt, None; J. Smolen, Abbvie, 5, 6; T. Pincus, Medical History Services LLC, 8, 9, 10, 12; N. Shadick, BMS, 5, Mallinckrodt, 5, Sanofi/Regeneron, 5, Crescendo Biosciences, 5; J. Katz, Samumed, 5; L. Santacroce, None; J. Stratton, None; D. Solomon, Abbvie, 5, Amgen, 5, Genentech, 5; P. Chatpar, None; M. Stocks, None; B. Mundell, None; C. Downey, None; K. Torralba, GlaxoSmithKline, 12, Clinical Trials Support, UCB, 2, Exagen, 2, Aurinia Pharmaceuticals, 2, Ultrasound School of North American Rheumatologists (SUSONAR) Southern California Rheumatology Society (SCRS), 4, Janssen, 12, Support for educational programs, Radius Health, 12, Support for educational programs, Amgen, 12, Support for educational programs, Novartis, 2, 12, Clinical Trials Support, Pfizer, 12, Support for educational programs, AstraZeneca, 12, Clinical Trials Support; D. White, None; M. Baudek, None; S. Szlembarski, None; S. Barnhart, None; J. Bilal, None; A. Redford, None; D. Lee, None; J. Buchfuhrer, None; H. Kramer, None; C. Kwoh, Lilly, 5, Abbvie, 5, Kolon Tissue Gene, 12, DSMB, Regeneron, 1, LG Chem, 1; M. Villatoro-Villar, None; A. Patnaik, None; E. Guzman, None; R. Trachtman, None; J. Tesser, Bristol-Myers Squibb, 1, 2, 5, 6, Janssen, 1, 2, 5, 6, Eli Lily, 1, 2, 5, 6, Pfizer, 1, 2, 5, 6, AbbVie, 1, 2, 5, 6, Astra Zeneca, 1, 2, 6, GlaxcoSmithKline, 6, Amgen, 5, 6, Boehringer Ingelheim, 5, Genentech, 5, Horizon Therapeutics plc, 5, SunPharma, 5, Gilead, 2, 5, Novartis, 2, 5, Celgene, 5, Merck KG, 5, Sandoz, 5, Setpoint, 5, UCB Pharma, 5, Crescendo Biosciences/Myriad, 6, Sanofi-Genzyme, 1, 2, 6, Aurinia, 1, 2, 6, Samumed/Biosplice, 1, 2, 5, Vorso, 5, Selecta, 5, Exagen, 5, CSL Behring, 5, Organogenesis, 5, D R L Pharma, 5, Emerald Health, 5; D. Music, None; L. Mickey, None; M. Amin, Horizon, 6, Lilly, 6; J. Potter, None; J. Sundhar, Abbvie, 6, Amgen, 6, Sanofi, 6, novartis, 6, pfizer, 6, medac, 6; J. Sheingold, None; J. Schmukler, None; D. Horowitz, None; H. Gulko, None; R. Quinet, None; S. Dhulipala, None; R. Patel, None; C. Keshavamurthy, None; G. Carvajal, None; R. Dunn, None; B. Kumar, None; A. Lenert, None; H. Zembrzuska, None; M. Gebre, None; P. Lenert, None; A. Anandarjah, None; A. Yang, None; L. Grinnell-Merrick, Abbvie, 2, 6, Amgen, 2, 6, Novartis, 2, 6, Sanofie/Regeneron, 2, 6, Janssen, 2, 6, UCB, 2, Avion, 2, 6, Pfizzer, 2, Celegene, 2, 6, Novartis, 12, As of April 26, 2021 I am a full time employee of Novartis, I continue to work per diem at the University of Rochester Dept of Allergy, Immunology and Rheumatology; S. Goldsmith, None; J. Zelie, None; L. Wise, None; N. Zagelbaum Ward, None; J. Kaine, Sanofi-Genzyme, 3, 7.

To cite this abstract in AMA style:

Ellrodt J, Smolen J, Pincus T, Shadick N, Katz J, Santacroce L, Stratton J, Solomon D, Chatpar P, Stocks M, Mundell B, Downey C, Torralba K, White D, Baudek M, Szlembarski S, Barnhart S, Bilal J, Redford A, Lee D, Buchfuhrer J, Kramer H, Kwoh C, Villatoro-Villar M, Patnaik A, Guzman E, Trachtman R, Tesser J, Music D, Mickey L, Amin M, Potter J, Sundhar J, Sheingold J, Schmukler J, Horowitz D, Gulko H, Quinet R, Dhulipala S, Patel R, Keshavamurthy C, Carvajal G, Dunn R, Kumar B, Lenert A, Zembrzuska H, Gebre M, Lenert P, Anandarjah A, Yang A, Grinnell-Merrick L, Goldsmith S, Zelie J, Wise L, Zagelbaum Ward N, Kaine J. Satisfaction with a Virtual Learning Collaborative Aimed at Implementing Treat to Target (TTT) in Rheumatoid Arthritis (RA) [abstract]. Arthritis Rheumatol. 2021; 73 (suppl 9). https://acrabstracts.org/abstract/satisfaction-with-a-virtual-learning-collaborative-aimed-at-implementing-treat-to-target-ttt-in-rheumatoid-arthritis-ra/. Accessed .

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