Background/Purpose: Understanding patient goals and concerns is essential for aligning treatment decisions with patient preferences and supporting effective patient-clinician partnerships. Yet, little is known about the goals and concerns of people with rheumatoid arthritis (RA) or gout. In this study, we aim to understand the primary goals and concerns expressed by veterans with RA and/or gout and how they envision working in partnership with their clinicians to achieve their goals or allay their concerns.

Methods: Veterans with RA and/or gout (n=283) at a busy rheumatology clinic completed a paper pre-visit survey immediately prior to a clinic visit. The survey included three open-ended questions: (1) What is your #1 concern or goal related to your arthritis?; (2) How can we help you achieve your goals?; and, (3) What steps can you take to help achieve your goals? Data were collected between April and September 2019. We conducted a content analysis of patient responses. Codes were developed using grounded theory, with input from rheumatologists and adults with RA. If multiple themes were mentioned in response to any question, the response received multiple codes.

Results: We identified five domains of veteran’s goals or concerns, including symptoms (64%), treatment goals (54%), managing RA or gout (13%), effect on daily living (12%), and clinical course of illness (9%). The most common themes in each domain were pain (55%), reducing symptoms or controlling disease (47%), accessing treatment (6%), functioning (5%), and disease progression or damage (6%), respectively (Figure 1). Veterans indicated that rheumatologists could help them achieve their goals by providing treatment (37%), discussing or educating around treatment options (18%), or monitoring and assessing disease status (9%) (Figure 2). Veterans felt they (themselves) could achieve their goals through a combination of self-care activities (55%), such as exercising or being physically active (28%) and managing weight or eating a healthy diet (18%), and by following treatment recommendations (35%) (Figure 2).

Conclusion: Veterans with RA and/or gout are largely concerned around improving pain. While they most often report that clinicians and patients can work together to meet goals (e.g., provide treatment/follow treatment recommendations), other important areas include provider education or discussion around treatment options and patient self-care (exercise and diet). Understanding patients’ perceptions about their disease and what is most important to them can inform patients and clinicians working together to achieve shared treatment goals.

Figure 1. Frequency of Themes and Subthemes of 283 Responses to the Pre-Visit Survey: What is your number one concern or goal related to your arthritis?

Figure 2. Frequency of Themes and Subthemes of 283 Responses to the Pre-Visit Survey Questions: “How can we help you achieve your goals?” and “What steps can you take to achieve your goals?”

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/veterans-with-ra-and-gout-identify-their-goals-and-how-they-can-work-with-clinicians-to-achieve-their-goals/