Session Information
Date: Tuesday, November 10, 2015
Title: Health Services Research Poster III: Patient Reported Outcomes, Patient Education and Preferences
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose:
Doppler ultrasound (DUS) can detect subclinical joint inflammation and can be used to predict disease relapse or flare in patients with RA. The objectives of the present study were to assess 1) the current use of DUS, 2) if DUS and visual aids with explanation improved patient understanding of disease, and 3) whether exposure to DUS alters rheumatologists’ clinical practice.
Methods:
Australian rheumatologists were invited to take part in the DEDUCE Medical Practice Activity that enrolled 4−6 RA patients from each practice aged ≥18 years in DAS28 remission. Rheumatologists and patients completed a pre-activity survey assessing experience of DUS prior to DUS evaluation using the US7 score. Rheumatologists discussed results with patients using specifically developed visual aids. Patients and rheumatologists then completed post-activity questionnaires followed by a final survey six months later. Summary statistics were used as appropriate.
Results:
Eighty patients recruited by 21 rheumatologists completed pre-activity questionnaires. Patients who had previously undergone DUS found it improved their understanding of RA (18/19, 95%) and likelihood of medication adherence (16/19, 84%). Fifteen of the 21 rheumatologists had previously used DUS. Ten (67%) used DUS in patients in clinical remission and low disease activity (LDA) while 12/15 (80%) and 9/15 (60%) agreed it aided patient communication and medication adherence, respectively. The most common reasons for not using DUS were cost, inconvenience, and concern regarding usefulness and practicality.
Sixty six patients completed post-activity questionnaires. Of the 58 patients who had post-DUS discussions with their rheumatologist, 51 (88%) reported these improved understanding of their disease and 55 (95%) believed that it will encourage them to take medications as prescribed. Fifty of the 61 (82%) patients whose discussions utilised the visual aids found them useful. Overall, 56/66 (85%) of patients agreed DUS was useful in assessing disease activity.
Immediately post-activity, 20/21 (95%) of rheumatologists felt they would use DUS to guide therapeutic decisions and 16/21 (76%) found the visual aids useful for patient communication. Thirteen of 21 (62%) thought DUS would aid patient medication adherence.
Six months post-activity, all but one physician (95%) intended to continue to use DUS in their clinical practice. 15/21 (71%) of the rheumatologists had incorporated DUS into routine clinical practice, mainly for patients in LDA. Nineteen rheumatologists (91%) believed DUS aided patient understanding and 17 (81%) believed it assisted communication with patients.
Conclusion: Almost all rheumatologists and patients who experienced DUS felt that it was a useful clinical tool. Communication of results using visual aids enabled patients to better understand their disease and increased the likelihood of medication adherence. Importantly, at 6 months the vast majority of participating rheumatologists had incorporated DUS into routine clinical practice.
To cite this abstract in AMA style:
Joshua F, Bailey C, Marabani M, Romas E, White R, Wong P. The Use of Doppler Ultrasound in Patients with Rheumatoid Arthritis Improves Patient Understanding of Disease and Adherence to Treatment and Alters Clinical Practice [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/the-use-of-doppler-ultrasound-in-patients-with-rheumatoid-arthritis-improves-patient-understanding-of-disease-and-adherence-to-treatment-and-alters-clinical-practice/. Accessed .« Back to 2015 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-use-of-doppler-ultrasound-in-patients-with-rheumatoid-arthritis-improves-patient-understanding-of-disease-and-adherence-to-treatment-and-alters-clinical-practice/