Background “Treating to target (T2T) recommendations” are formulated to improve the management of rheumatoid arthritis (RA) in clinical practice. The following four overarching principles are highlighted: “(A) The treatment of rheumatoid arthritis must be based on a shared decision between patient and rheumatologist, (B) The primary goal of treating the patient with rheumatoid arthritis is to maximise long-term health-related quality of life through control of symptoms, prevention of structural damage, normalisation of function and social participation, (C) Abrogation of inflammation is the most important way to achieve these goals, (D) Treatment to target by measuring disease activity and adjusting therapy accordingly optimises outcomes in rheumatoid arthritis.” However, the T2T recommendations do not specify concrete and effective methods to implement.
Objectives We developed an original computerized touch-panel system for facilitating the assessment of RA, called MiRAi. We upgraded MiRAi to allow patients to track their RAPID3 score independently on their monitor even before consulting their physician. We evaluated whether this novel touch-panel system promoted shared decision making between patient and rheumatologist.
Methods After obtaining the informed consent, registered nurses asked RA patients to fill out the same questionnaires before, and 6 months after, introduction of the touch-panel system. The questionnaires were anonymous and the physicians were blinded. The questionnaire included six visual analog scales (VAS): agreement to each of the four overarching principles, degree of “shared decision-making”, and degree of satisfaction with the care received. Since the key concept of the T2T is summarized in principle “D” as outlined above, we classified subjects with the lower quartile VAS of “D” (before introduction of this system) in the “poor comprehension group” and the rest in the “fair/good comprehension group”. We then compared the VAS between these two groups.
Results The IRB approved this project. The initial evaluation was obtained from 302 patients. Six months after this system was introduced, the second evaluation was collected from 261 patients (86.4%). Whereas the “Poor comprehension group” showed improvement in all VAS except the RAPID3 score, the “fair/good comprehension group” showed improvement in RAPID3 and as well as satisfaction with the medical care they received.
Conclusions The novel touch-panel system may promote comprehension and implementation of T2T recommendations.
Kagawa K, et al. Usefulness of touch-panel method for the evaluation of functional ability in rheumatoid arthritis. Ann Rheum Dis 2012;71(Suppl 3):742
Disclosure of Interest None Declared
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