Evidence map›Paper›PMID 27793171›Full record

ArticleArthritis research & therapy2016

Evaluation of a patient decision aid for initiating disease modifying anti-rheumatic drugs.

Ingrid Nota, Constance H C Drossaert, Erik Taal, Harald E Vonkeman, Cees J Haagsma, Mart A F J van de Laar

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Article in Arthritis research & therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
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  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Ingrid NotaDepartment of Psychology, Health and Technology, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands. i.nota@utwente.nl.ORCID 0000-0002-4106-1286
Constance H C DrossaertDepartment of Psychology, Health and Technology, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands.
Erik TaalDepartment of Psychology, Health and Technology, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands.
Harald E VonkemanDepartment of Psychology, Health and Technology, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands.
Cees J HaagsmaDepartment of Rheumatology, Ziekenhuisgroep Twente, PO Box 7600, 7600, SZ, Almelo, The Netherlands.
Mart A F J van de LaarDepartment of Psychology, Health and Technology, University of Twente, PO Box 217, 7500, AE, Enschede, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAccording to international guidelines, treatment of inflammatory arthritis should be based on a shared decision between patient and rheumatologist. Furthermore, patients with inflammatory arthritis have high need of information and want to be more actively involved in medical decision-making. To facilitate shared decision-making and support patients in choosing between disease modifying anti-rheumatic drugs (DMARDs), a web-based patient decision aid (PtDA) was developed. This study evaluated use, appreciation and effect of this PtDA.

methodsA post-test only study with a historical comparison group was conducted. In a two-year period, all patients diagnosed with rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis, who were deciding whether to start a (different) DMARD were invited to participate. In the first year, patients received standard information (comparison group). In the second year, patients were referred to the PtDA (intervention group). In both groups, a questionnaire was sent four weeks after consulting the rheumatologist. Patient characteristics included sociodemographic, health-related and preference-related variables. Process measures were for use and appraisal of the PtDA (intervention group only). The primary outcome measure was patients' perceived role in medical decision-making. Secondary outcome measures comprised satisfaction with the decision-making process and the decision, beliefs about medication, adherence to medication and trust in the physician.

resultsWe received 158/232 questionnaires (68 %) from the comparison group and 123/200 (61 %) from the intervention group. The PtDA was used by 69/123 patients (57 %) in the intervention group. Patients who used the PtDA highly appreciated it and perceived it as easy to use and helpful. Relative to the comparison group, patients in the intervention group perceived a more active role in medical decision-making and decisions were more in line with patients' personal preferences. Other outcomes showed no significant difference between the two groups.

conclusionThe web-based PtDA was highly appreciated and perceived as helpful for decision-making. Implementation of the PtDA in rheumatology practice was associated with a significantly larger proportion of patients perceiving an active role in medical decision-making and decisions were more in line with patients' personal preferences. The PtDA can be a valuable aid in improving patient participation in decision-making about DMARDs.

Indexed as

Decision MakingDecision Support TechniquesAgedAntirheumatic AgentsFemaleHumansMaleMiddle AgedPatient ParticipationRheumatic DiseasesAntirheumatic AgentsDMARDsInflammatory arthritisPatient decision aidPatient participationShared decision-making

Identifiers

PMID27793171
PMCPMC5086044

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.