Evidence map›Paper›PMID 34962093›Full record

ArticleACR open rheumatology2022

Evaluation of an Intervention to Support Patient-Rheumatologist Conversations About Escalating Treatment in Patients with Rheumatoid Arthritis: A Proof-of-Principle Study.

Maria I Danila, Lang Chen, Eric M Ruderman, Justin K Owensby, Ronan O'Beirne, Joshua A Melnick, Leslie R Harrold, David Curtis, W Benjamin Nowell, Jeffrey R Curtis

Abstract read
In one paragraph

Article in ACR open rheumatology, 2022. 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

10 authors.

Maria I DanilaUniversity of Alabama at Birmingham, Birmingham, Alabama.ORCID https://orcid.org/0000-0001-9246-6200
Lang ChenUniversity of Alabama at Birmingham, Birmingham, Alabama.
Eric M RudermanNorthwestern University, Chicago, Illinois.ORCID https://orcid.org/0000-0002-1791-8729
Justin K OwensbyUniversity of Alabama at Birmingham, Birmingham, Alabama.ORCID https://orcid.org/0000-0002-6993-2880
Ronan O'BeirneUniversity of Alabama at Birmingham, Birmingham, Alabama.
Joshua A MelnickUniversity of Alabama at Birmingham, Birmingham, Alabama.
Leslie R HarroldUniversity of Massachusetts Medical School, Worcester, Massachusetts.
David CurtisGlobal Healthy Living Foundation, Upper Nyack, New York.
W Benjamin NowellGlobal Healthy Living Foundation, Upper Nyack, New York.ORCID https://orcid.org/0000-0002-4951-6476
Jeffrey R CurtisUniversity of Alabama at Birmingham, Birmingham, Alabama.ORCID https://orcid.org/0000-0002-8907-8976

Funding

Pfizer Independent Grants for Learning and Change 20882063
6 · The paper itself

Abstract

objectiveThis study's objective was to test whether an online video intervention discussing appropriate treatment escalation improves willingness to change treatment in people living with rheumatoid arthritis (RA).

methodsWe conducted a controlled, randomized trial among patients with RA enrolled in ArthritisPower, a United States patient registry. We recruited participants by email and surveyed their assessment of disease activity (patient global), satisfaction with disease control (patient acceptable symptom state), attitudes about RA medications, decisional conflict (decisional conflict scale), and willingness to modify RA treatment (choice predisposition scale, higher scores are better) if or when recommended by their rheumatologist. Intervention groups watched educational videos relevant to a treat-to-target (T2T) strategy, whereas control groups viewed vaccination-related videos as an "attention control." We compared the between-group difference in patients' willingness to modify RA treatment (primary outcome) and difference in decisional conflict about changing RA treatment (secondary outcome) after watching the videos using t tests.

resultsParticipants with self-reported RA (n = 208) were 90% White and 90% women, with a mean (standard deviation) age of 50 (11) years, and 52% reported familiarity with the RA T2T strategy. We found a significant improvement in between-group difference in willingness to change RA treatment among intervention versus control participants (0.49 [95% confidence interval 0.09-0.88], P = 0.02). The effect size (Glass's delta) for the intervention was 0.48. Decisional conflict about treatment change decreased, but the between-group difference was not significant.

conclusionThis novel educational patient-directed intervention discussing appropriate treatment escalation was associated with improved willingness to change RA treatment if or when recommended by a rheumatologist. Further studies should evaluate whether this change in patients' predisposition translates into actual treatment escalation.

Identifiers

PMID34962093
PMCPMC8992469

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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.