Abstract
Objective. To evaluate the effect of a patient-centered rheumatoid arthritis (RA) treat-to-target (T2T) disease management approach on patient outcomes and patient satisfaction with care. Methods. In this longitudinal, observational pilot study, rheumatologists implemented a modified T2T approach that integrated Patient Reported Outcomes Measurement Information System (PROMIS) measures for depression, fatigue, pain interference, physical function, and social function into RA care. Study participants selected 1 PROMIS domain to target treatment and completed quarterly follow-up assessments. Participants were classified as improved if their Clinical Disease Activity Index (CDAI) changed by > 5 points. Change in PROMIS t scores was examined for the group with improved CDAI, and then compared to those with unchanged or worsened CDAI. Satisfaction with care was assessed using multiple measures, including the Functional Assessment of Chronic Illness Therapy–Treatment Satisfaction–Patient Satisfaction Scale. Results. The analytical sample (n = 119, median age 57 years, 90.8% female) was split between those with CDAI > 10 (n = 63) and CDAI ≤ 10 (n = 53). At 1 year, there was improvement in CDAI by > 5 points in 66% and 13% of individuals with baseline CDAI > 10 and baseline CDAI ≤ 10, respectively. Across all participants, improvement in CDAI by > 5 points correlated with improvements in the 5 PROMIS domains. Satisfaction with RA treatment also increased. Conclusion. The integration of PROMIS measures into the T2T approach for RA care was associated with improvements in disease activity, and improvement in disease activity was associated with improvements in PROMIS measures.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1002-1008 |
| Number of pages | 7 |
| Journal | Journal of Rheumatology |
| Volume | 50 |
| Issue number | 8 |
| DOIs | |
| State | Published - Aug 1 2023 |
Funding
This study was funded by Pfizer, Inc. The funder had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. 1G.J. Greene, PhD, A. Muftic, BSW, K. Kaiser, PhD, A.R. Eisenstein, PhD, D. Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; 2J.L. Beaumont, MS, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, and Clinical Outcomes Solutions, Tucson, Arizona; 3E.J. Bacalao, BS, A.M. Mandelin, MD, PhD, E.M. Ruderman, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. DC and EMR have received compensation from Pfizer, Inc., for consulting work unrelated to this study. AMM has received compensation as a member of Pfizer’s speakers’ bureau. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. G.J. Greene, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N. Michigan Ave, 22-013, Chicago, IL 60611, USA. Email: [email protected]. Accepted for publication April 21, 2023.
Keywords
- disease management
- outcome assessment
- patient satisfaction
- patient-centered care
- rheumatoid arthritis
ASJC Scopus subject areas
- Rheumatology
- Immunology and Allergy
- Immunology