OBJECTIVE: Despite the importance of achieving tight control, many patients with rheumatoid arthritis (RA) are not effectively treated with disease-modifying antirheumatic drugs. The objective of this study was to develop a decision support tool to inform RA patients with ongoing active disease about the risks and benefits related to biologic therapy. METHODS: We developed a balanced, web-based, decision support tool. Options, values, and probabilistic information were described using theoretically supported formulations. We conducted a pre-/posttest study to assess preliminary evidence of the tool's efficacy in improving knowledge related to biologics, clarity of values, willingness to take a biologic, and informed choice. RESULTS: We interviewed 104 subjects (mean age 62 years, 84% women, 87% white, and median duration of RA 8 years). Knowledge (coded on a 0-20 scale) and willingness to take a biologic (coded on a 0-10 scale) significantly increased after viewing the tool (mean differences 2.3 and 1.4, respectively; P < 0.0001 for both). Perceived knowledge and values clarity (coded on 0-100 scales) also significantly improved (mean differences 20.4 and 20.8, respectively; P < 0.0001 for both). The proportion of subjects making an informed value-concordant choice increased substantially from 35% to 64%. CONCLUSION: A tool designed to effectively communicate the risks and benefits associated with biologic therapy increased knowledge, patient willingness to escalate care, and the likelihood of making an informed choice. The results of this study support the need for a clinical trial to examine the impact of the tool in clinical practice.
OBJECTIVE: Despite the importance of achieving tight control, many patients with rheumatoid arthritis (RA) are not effectively treated with disease-modifying antirheumatic drugs. The objective of this study was to develop a decision support tool to inform RApatients with ongoing active disease about the risks and benefits related to biologic therapy. METHODS: We developed a balanced, web-based, decision support tool. Options, values, and probabilistic information were described using theoretically supported formulations. We conducted a pre-/posttest study to assess preliminary evidence of the tool's efficacy in improving knowledge related to biologics, clarity of values, willingness to take a biologic, and informed choice. RESULTS: We interviewed 104 subjects (mean age 62 years, 84% women, 87% white, and median duration of RA 8 years). Knowledge (coded on a 0-20 scale) and willingness to take a biologic (coded on a 0-10 scale) significantly increased after viewing the tool (mean differences 2.3 and 1.4, respectively; P < 0.0001 for both). Perceived knowledge and values clarity (coded on 0-100 scales) also significantly improved (mean differences 20.4 and 20.8, respectively; P < 0.0001 for both). The proportion of subjects making an informed value-concordant choice increased substantially from 35% to 64%. CONCLUSION: A tool designed to effectively communicate the risks and benefits associated with biologic therapy increased knowledge, patient willingness to escalate care, and the likelihood of making an informed choice. The results of this study support the need for a clinical trial to examine the impact of the tool in clinical practice.
Authors: E Keystone; P Emery; C G Peterfy; P P Tak; S Cohen; M C Genovese; M Dougados; G R Burmester; M Greenwald; T K Kvien; S Williams; D Hagerty; M W Cravets; T Shaw Journal: Ann Rheum Dis Date: 2008-04-03 Impact factor: 19.103
Authors: Josef S Smolen; Robert Landewé; Ferdinand C Breedveld; Maxime Dougados; Paul Emery; Cecile Gaujoux-Viala; Simone Gorter; Rachel Knevel; Jackie Nam; Monika Schoels; Daniel Aletaha; Maya Buch; Laure Gossec; Tom Huizinga; Johannes W J W Bijlsma; Gerd Burmester; Bernard Combe; Maurizio Cutolo; Cem Gabay; Juan Gomez-Reino; Marios Kouloumas; Tore K Kvien; Emilio Martin-Mola; Iain McInnes; Karel Pavelka; Piet van Riel; Marieke Scholte; David L Scott; Tuulikki Sokka; Guido Valesini; Ronald van Vollenhoven; Kevin L Winthrop; John Wong; Angela Zink; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2010-05-05 Impact factor: 19.103
Authors: Josef S Smolen; Andre Beaulieu; Andrea Rubbert-Roth; Cesar Ramos-Remus; Josef Rovensky; Emma Alecock; Thasia Woodworth; Rieke Alten Journal: Lancet Date: 2008-03-22 Impact factor: 79.321
Authors: Benjamin D Sommers; Clair J Beard; Anthony V D'Amico; Irving Kaplan; Jerome P Richie; Richard J Zeckhauser Journal: Cancer Date: 2008-10-15 Impact factor: 6.860
Authors: Arthur Kavanaugh; Josef S Smolen; Paul Emery; Oana Purcaru; Edward Keystone; Lance Richard; Vibeke Strand; Ronald F van Vollenhoven Journal: Arthritis Rheum Date: 2009-11-15
Authors: J Smolen; R B Landewé; P Mease; J Brzezicki; D Mason; K Luijtens; R F van Vollenhoven; A Kavanaugh; M Schiff; G R Burmester; V Strand; J Vencovsky; D van der Heijde Journal: Ann Rheum Dis Date: 2008-11-17 Impact factor: 19.103
Authors: R Fleischmann; J Vencovsky; R F van Vollenhoven; D Borenstein; J Box; G Coteur; N Goel; H-P Brezinschek; A Innes; V Strand Journal: Ann Rheum Dis Date: 2008-11-17 Impact factor: 19.103
Authors: P Emery; E Keystone; H P Tony; A Cantagrel; R van Vollenhoven; A Sanchez; E Alecock; J Lee; J Kremer Journal: Ann Rheum Dis Date: 2008-07-14 Impact factor: 19.103
Authors: Eili Y Klein; Elena M Martinez; Larissa May; Mustapha Saheed; Valerie Reyna; David A Broniatowski Journal: J Gen Intern Med Date: 2017-06-20 Impact factor: 5.128
Authors: Alexandra L Mathews; Adriana Coleska; Patricia B Burns; Kevin C Chung Journal: Arthritis Care Res (Hoboken) Date: 2016-03 Impact factor: 4.794
Authors: Jennifer L Barton; Laura Trupin; Chris Tonner; John Imboden; Patricia Katz; Dean Schillinger; Edward Yelin Journal: J Rheumatol Date: 2014-07 Impact factor: 4.666