In this project, we will extend and rigorously evaluate past investments made by the NIH, ACR, and AHRQ in novel health information technology developed by the project team to: enable the systematic collection and integration of Patient Reported Outcome (PRO) and healthcare provider data in routine clinical practice;make use of this data to facilitate patient-provider interaction around optimal use of rheumatoid arthritis (RA) therapies;integrate this data with information in Electronic Health Record (EHR) systems;and demonstrate benefit for both process and outcomes among patients with RA.
Our specific aims are:
Aim 1 : To refine and integrate a novel approach to the electronic collection and use of PRO data from RA patients to facilitate better patient-provider communication, and achievement of Treat to Target (T2T) goals. We will further pilot-test novel and recently-completed technologies developed by our research team: 1) the RhEumatoid Arthritis Disease activitY (READY) electronic measurement tool that will collect data from patients using multiple existing, validated PRO instruments at physician offices and patients'homes via the Internet and smari:phones (e.g. iPhone);2) a risk communication tool focused on optimal use of biologic agents for RA patients considering changes in therapy;and 3) linked EHR-based data available through the ACR's new national registry, the Rheumatology Informatics System for Effectiveness (RISE). With critical input from many key stakeholders, including patients, we will refine this integrated tool in a variety of clinical practices using commonly available computing devices (e.g. iPad) to create a highly generalizable resource that can be deployed across both community and academic practice settings nationally.
Aim 2 : To conduct a cluster-randomized study to examine the effect of the integrated electronic tool to optimize RA patient care. We will test the hypothesis that RA patients receiving care in the physician practices randomized to receive the intervention tool will attain better RA outcomes as quantified by the proportion of patients in each physicians'practice that have achieved a T2T goal of low disease activity or remission one year after randomization.

Public Health Relevance

Past treat to target studies have important problems with respect to generalizability, physician autonomy and acceptability (at least in the U.S.), and practicality for implementation in routine clinical care. Therefore the proposed study will incorporate the salubrious elements of published treat-to-target trials but will avoid their limitations by employing a practical, real-worid design that emphasizes a patient-centered treatment approach supported by innovative health information technology tools that will be rigorously tested.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Comprehensive Center (P60)
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Special Emphasis Panel (ZAR1-KM)
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University of Alabama Birmingham
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Hartman, Holly; Wang, Yuge; Schroeder Jr, Harry W et al. (2018) Absorbance summation: A novel approach for analyzing high-throughput ELISA data in the absence of a standard. PLoS One 13:e0198528
Stoll, Matthew L; Pierce, M Kathy; Watkins, Jordan A et al. (2018) Akkermansia muciniphila is permissive to arthritis in the K/BxN mouse model of arthritis. Genes Immun :
Curtis, Jeffrey R; Chen, Lang; Danila, Maria I et al. (2018) Routine Use of Quantitative Disease Activity Measurements among US Rheumatologists: Implications for Treat-to-target Management Strategies in Rheumatoid Arthritis. J Rheumatol 45:40-44
Stoll, Matthew L; Weiss, Pamela F; Weiss, Jennifer E et al. (2018) Age and fecal microbial strain-specific differences in patients with spondyloarthritis. Arthritis Res Ther 20:14
Curtis, Jeffrey R; Chen, Lang; Higginbotham, Phillip et al. (2017) Social media for arthritis-related comparative effectiveness and safety research and the impact of direct-to-consumer advertising. Arthritis Res Ther 19:48
Yun, Huifeng; Xie, Fenglong; Beyl, Randall N et al. (2017) Risk of Hypersensitivity to Biologic Agents Among Medicare Patients With Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 69:1526-1534
Paulsen, Jesseca A; Ptacek, Travis S; Carter, Stephen J et al. (2017) Gut microbiota composition associated with alterations in cardiorespiratory fitness and psychosocial outcomes among breast cancer survivors. Support Care Cancer 25:1563-1570
Curtis, Jeffrey R; Chen, Lang; Greenberg, Jeffrey D et al. (2017) The clinical status and economic savings associated with remission among patients with rheumatoid arthritis: leveraging linked registry and claims data for synergistic insights. Pharmacoepidemiol Drug Saf 26:310-319
Yen, Po-Yin; Lara, Barbara; Lopetegui, Marcelo et al. (2016) Usability and Workflow Evaluation of ""RhEumAtic Disease activitY"" (READY). A Mobile Application for Rheumatology Patients and Providers. Appl Clin Inform 7:1007-1024
Stoll, Matthew L; Cron, Randy Q (2016) The microbiota in pediatric rheumatic disease: epiphenomenon or therapeutic target? Curr Opin Rheumatol 28:537-43

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