The proposal addresses the observed disparities in treatments and outcomes experienced by persons with RA who are members of racial and ethnic minorities, have low levels of English language proficiency, and are of lower socioeconomic status. The proposal also addresses the observation that persons with RA with a primary language other than English and those born outside the U.S. experience a greater discordance between their assessments of disease activity and those of their providers. The overarching aim of the proposed project is to improve communication between patients with RA and their providers about disease activity and treatment choices. It is hypothesized that improved communication may provide a method of improving access to treatments of proven effectiveness for RA and in so doing reduce differences in outcomes.
The specific aims of the proposed D&F are to: 1) assess the quality of information exchange between patients and providers regarding disease activity and treatment choices in RA in a cohort of diverse patients;2) develop a computerized tool to improve communication about patient-reported symptoms and treatment preferences;and, 3) provide a preliminary assessment of the utility of the tool in terms of its feasibility in a clinical environment and the congruence between patients and providers in the symptoms addressed in an encounter by conducting a small pilot randomized trial.
The specific aims will be achieved by analysis of data from the RA Outcomes Study (RA-OS). The RA-OS includes a uniquely diverse set of 450 respondents. The first annual survey of the RA-OS will include items to obtain the data for Aim 1. The information from the analysis of the survey data will be combined with information from focus groups among members of the RA-OS and physicians and that from conscientious literature reviews to develop the computerized tool in Aim 2.
In Aim 3, 50 members of the RA-OS will participate in the pilot trial of the tool administered in a clinic visit. The overall goal of the project is to improve the quality of communication between patients with RA and providers and, therefore, reduce disparities in RA outcomes by improving patients'understanding of the disease and its treatments.
Prior investigations have revealed substantial differences by race/ethnicity in the treatments received for RA and in RA outcomes;another investigation found discordance between patients and providers in the assessment of disease activity, with the discordance greater for patients who are non-English speakers and immigrants. The proposed project is designed to develop a tool to improve communication between patients and providers with the goal of reducing the discordance that may result in disparities in treatment.
|Barton, Jennifer L; Hulen, Elizabeth; Schue, Allison et al. (2018) Experience and Context Shape Patient and Clinician Goals For Treatment of Rheumatoid Arthritis: A Qualitative Study. Arthritis Care Res (Hoboken) 70:1614-1620|
|Yelin, Edward; Yazdany, Jinoos; Trupin, Laura (2018) Relationship Between Poverty and Mortality in Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 70:1101-1106|
|Knight, Andrea M; Trupin, Laura; Katz, Patricia et al. (2018) Depression Risk in Young Adults With Juvenile- and Adult-Onset Lupus: Twelve Years of Followup. Arthritis Care Res (Hoboken) 70:475-480|
|Patel, Zubin; Lu, Xiaoming; Miller, Daniel et al. (2018) A plausibly causal functional lupus-associated risk variant in the STAT1-STAT4 locus. Hum Mol Genet :|
|Leonard, Dag; Svenungsson, Elisabet; Dahlqvist, Johanna et al. (2018) Novel gene variants associated with cardiovascular disease in systemic lupus erythematosus and rheumatoid arthritis. Ann Rheum Dis 77:1063-1069|
|Heshin-Bekenstein, Merav; Perl, Liat; Hersh, Aimee O et al. (2018) Final adult height of patients with childhood-onset systemic lupus erythematosus: a cross sectional analysis. Pediatr Rheumatol Online J 16:30|
|Jafri, Kashif; Ogdie, Alexis; Qasim, Atif et al. (2018) Discordance of the Framingham cardiovascular risk score and the 2013 American College of Cardiology/American Heart Association risk score in systemic lupus erythematosus and rheumatoid arthritis. Clin Rheumatol 37:467-474|
|Mccormick, Natalie; Trupin, Laura; Yelin, Edward H et al. (2018) Socioeconomic Predictors of Incident Depression in Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken) 70:104-113|
|Lanata, Cristina M; Nititham, Joanne; Taylor, Kimberly E et al. (2018) Genetic contributions to lupus nephritis in a multi-ethnic cohort of systemic lupus erythematous patients. PLoS One 13:e0199003|
|Azizoddin, Desiree R; Jolly, Meenakshi; Arora, Shilpa et al. (2018) Patient Reported Outcomes Predict Mortality in Lupus. Arthritis Care Res (Hoboken) :|
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