Patient Decision Aids – Using them to Optimize Early Treatment in those with Rheumatoid Arthritis

Scientific Study Title: Optimizing early treatment strategies in early RA through shared decision-making

Co-Principal Investigators:

Claire Barber MD, PhD, Assistant Professor, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Research Scientist, Arthritis Research Canada

Glen Hazlewood MD, PhD, Assistant Professor, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Research Scientist, Arthritis Research Canada

Study Start Date: September 2019

Study End Date: August 2021

Why do this research?

Patient decision aids are standardized tools that can help patients and their doctors talk about treatment options together.

When patients receive a diagnosis of a chronic disease such as rheumatoid arthritis (RA), they may feel overwhelmed and find it difficult to make decisions about treatment at the first rheumatology appointment. Decision aids assist patients to make treatment decisions based on their values.

Although there have been many studies over the last 20 years that highlight the benefits of decision aids in healthcare, we do not have a good understanding about the best way to use these tools in clinic appointments.

In this study, we will use a decision aid that we have already developed and tested to help patients who are newly diagnosed with RA make decisions about treatments. Our focus will be to understand the best way to use this tool in the clinic.

What will we be done?

Phase 1: Implementation of the Patient Decision Aid.

During phase 1, the researchers, physicians and clinic staff will work collaboratively to develop a plan for putting this tool into practice. We will identify potential barriers and come up with solutions. Once we develop the plan, we will recruit patients with early RA to participate in the study.  During appointments, a member of the healthcare team will work with the patients to use the decision aid.  We will follow the patients at regular intervals to measure outcomes. At each stage of phase 1, we will work closely with the healthcare team.

Phase 2: Measurement of the Results of Phase 1.

In this phase of the study, we will measure the results of phase 1.  We will look at three general areas: early implementation outcomes (uptake, acceptability and appropriateness), service outcomes (safety, effectiveness, efficiency), and patient outcomes (satisfaction with decision-making and overall care, decisional conflict, disease activity and treatment adherence). The key outcome will be the uptake of the patient decision aid.

Co-Investigators:

Nick Bansback, MSc, PhD, Associate Professor, School of Population and Public Health, University of British Columbia, Scientist, Centre for Health Evaluation and Outcome Sciences,  Research Scientist, Arthritis Research Canada

Linda Li, PT, PhD, Professor, Canada Research Chair in Patient-Oriented Knowledge Translation, Harold Robinson / Arthritis Society Chair in Arthritic Diseases, Department of Physical Therapy, University of British Columbia, Senior Scientist of Clinical Epidemiology, Arthritis Research Canada

Dianne Mosher, MD, FRCPC, Associate Dean, Strategic Partnerships and Community Engagement, Cumming School of Medicine, University of Calgary, Calgary, AB

Collaborators:

Laurie Proulx, BComm, Vice President, Canadian Arthritis Patient Alliance

Dawn Richards, PhD, Vice President, Canadian Arthritis Patient Alliance

Research Staff:

Victoria Bohm, MSc, MPH, Research Coordinator, Division of Rheumatology, Department of Medicine, Cumming School of Medicine, University of Calgary

Who is funding this research?

Canadian Initiative for Outcomes in Rheumatology cAre (CIORA)