Trial reportArthritis care & research2026
Evaluation of a Novel Electric Health Record Sidecar Application to Display Rheumatoid Arthritis Clinical Outcomes During Clinic Visits: Results of a Stepped-Wedge Cluster Randomized Pragmatic Trial.
Trial report in Arthritis care & research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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17 authors.
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Abstract
objectiveWe developed a novel electronic health record sidecar application to visualize key rheumatoid arthritis (RA) outcomes, including disease activity, physical function, and pain, via a patient-facing graphical interface designed for use during outpatient visits ("RA PRO dashboard"). Initial qualitative studies showed positive perceptions from patients; here we assessed the effect of the RA PRO dashboard on patient decision-making, self-efficacy in symptom management, medication beliefs, and medication adherence in a randomized pragmatic trial.
methodsWe conducted an open cohort, stepped-wedge cluster-randomized trial at a single academic rheumatology clinic between February 2020 and August 2023. Rheumatology clinicians were randomized as clinician-patient clusters into four intervention sequences (5 time periods). Primary outcome measures derived from patient questionnaires were the 4-item SURE (Sure of myself, Understand information, Risk-benefit ratio, Encouragement) scale of decisional conflict; PROMIS-SE 4a (Patient-Reported Outcomes Measurement Information System-Self-Efficacy for Managing Symptoms); Beliefs about Medicines Questionnaire-Specific Necessity-Concerns differential; and medication adherence. Generalized estimating equations models were used to evaluate the effect of clinician access to the dashboard on each outcome.
resultsA total of 23 clinicians were included in the analysis, and 554 patients completed 1,083 study visits, of which 664 were in the intervention group. Adoption of the RA PRO dashboard by clinicians was highly variable. We observed limited effects of the intervention on the outcomes.
conclusionThis trial revealed no significant short-term effects of the RA PRO dashboard on measures of patient decision-making, self-efficacy, medication beliefs, or adherence. Despite previous qualitative work showing improvements in the care experience, this study suggests that the dashboard's impact on traditional behavioral outcomes, at least in the short term, is limited.
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