Patient involvement in rheumatoid arthritis care to improve disease activity-based management in daily practice: A randomized controlled trial

Abstract

ObjectiveTo evaluate the effect of an intervention to improve disease activity-based management of RA in daily clinical practice by addressing patient level barriers. MethodsThe DAS-pass strategy aims to increase patients’ knowledge about DAS28 and to empower patients to be involved in treatment (decisions). It consists of an informational leaflet, a patient held record and guidance by a specialized rheumatology nurse. In a Randomized Controlled Trial, 199 RA patients were randomized 1:1 to intervention or control group. Outcome measures were patient empowerment (EC-17; primary outcome), attitudes towards medication (BMQ), disease activity (DAS28) and knowledge about DAS28. ResultsOur strategy did not affect EC-17, BMQ, or DAS28 use. However it demonstrated a significant improvement of knowledge about DAS28 in the intervention group, compared to the control group. The intervention had an additional effect on patients with low baseline knowledge compared to patients with high baseline knowledge. ConclusionThe DAS-pass strategy educates patients about (the importance of) disease activity-based management, especially patients with low baseline knowledge. Practice ImplicationsThe strategy supports patient involvement in disease activity-based management of RA and can be helpful to reduce inequalities between patients in the ability to be involved in shared decision making.