Communication and Compliance Go Hand in Hand

Although patient education and patient adherence often take a back seat to medication management in rheumatoid arthritis (RA), several studies reported at the European League Against Rheumatism Annual Congress (EULAR 2016) in London last week, highlight the importance of better education and participation. The studies found that more active patient involvement led to better outcomes. Here is a summary of three of those studies:

Text Messaging Boosts Health Status in Rheumatoid Arthritis

A group of rheumatoid arthritis patients who received text messages and had regular motivational counseling sessions reduced their daily sitting time and replaced it with light physical activity.¹ Led by Tanja Thomsen, Ph.D., of the Copenhagen Centre for Arthritis Research in Denmark, the study included 75 adult patients with rheumatoid arthritis who self-reported their daily sitting time as more than five hours. Those included also had a Health Assessment Questionnaire score of less than 2.5. The patients took part in a 16-week behavioral intervention with three motivational counseling sessions and text messages that aimed to reduce daily sitting time. A control group of 75 healthy adults was included.  [[{"type":"media","view_mode":"media_crop","fid":"49411","attributes":{"alt":"@AlexanderRaths/Shutterstock.com","class":"media-image media-image-right","id":"media_crop_4092561636669","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"5960","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"font-size: 13.008px; line-height: 1.538em; float: right;","title":"@AlexanderRaths/Shutterstock","typeof":"foaf:Image"}}]]

There was a significant between-group difference in mean daily sitting time-the group of rheumatoid arthritis patients had a mean decrease of 1.61 hours per day versus 0.59 hours per day in the control group. The intervention group also saw beneficial differences in pain, fatigue and physical function.

A study reported last year in Rheumatology Network found that physical activity is often low in those with rheumatoid arthritis, but this patient group can benefit from increased amounts of exercise^.2

Patients Left with Unanswered Questions, Spurs Nonadherence

Many patients may be satisfied with their rheumatoid arthritis (RA) treatment, but there are also many patients who would like to discuss or change their currently prescribed treatment, according to researchers who reported on the results of a large patient-based survey.³

“Further understanding the responses from the survey will be important to facilitate communication between patients and healthcare providers, with the aim of improving treatment outcomes,” wrote lead abstract author Cheryl Koehn, Arthritis Consumer Experts, Vancouver.

Developed by the RA NarRAtive Global Advisory Panel, which includes 39 global RA experts (some of whom have RA), the survey included 3,649 patients. The average age was 52.8 years, and the median time since rheumatoid arthritis diagnosis was seven years. Thirty-four percent of respondents classified their current health as excellent/good. Although 78 percent of patients were satisfied with their rheumatoid arthritis medications, 70 percent wanted to take fewer medications; 57 percent worried their medications would fail, and 59 percent wanted more medication choices.

“The number or dosing frequency of medications was the most frequently cited aspect that patients would most like to change with respect to their current prescribed medications,” the abstract authors wrote. Still, 62 percent of patients were uncomfortable raising treatment concerns with their healthcare provider as they did not want to appear difficult.

“Expert” Patients, an Invaluable Resource for Developing Education Programs

The update of a program used in Belgium called Patient Partners demonstrates how patient experts can help retool educational programs, reported Jef Van Rompay, Patient Partners Program Belgium, Vosselaar, and co-authors.⁴

In the program, Patient Partners are expert patients who help train medical students, general practitioners and other providers about rheumatoid arthritis. Participants decided to update the Patient Partners Program for rheumatoid arthritis based on changing needs about early intensive treatment and patient beliefs and preferences in early rheumatoid arthritis. Based on the patient involvement and perspectives, program leaders created four content modules:  aspects of treatment participation, perceptions about medication, the patient and his/her environment, and active participation.

“Making medical students and healthcare providers aware of the patient perspective is an important step towards optimal care in RA,” the abstract authors concluded.

Disclosures:

The surveys for Koehn’s study were funded by Pfizer Inc.

References:

1. Thomsen T, Aadahl M, Beyer N, et al. “The Efficacy of Motivational Counselling and SMS-Reminders on Daily Sitting Time in Patients With Rheumatoid Arthritis: A Randomized Controlled Trial.” EULAR 2016. Abstract OPO286-HPR.

2. Baron-Faust R. “The Benefits for Boosting Fitness.” Rheumatology Network. August 3, 2015.

3. Koehn C, Dikranian A, Maniccia A, Bananis E. “Understanding the Importance of a Patient’s Role in the Management of RA: Results From a Patient-Based Survey Developed by the RA Narrative Global Advisory Panel.” EULAR 2016. Abstract OPO-248-PARE.

4. Van Rompay J, Hoet A, Geysen C, et al. “Updating the Patient Partner Educational Program for Rheumatoid Arthritis in Belgium: A Systematic Scientific-Based Approach Led by Patient Experts.” EULAR 2016. Abstract OP0014-PARE.