Patients With Psoriatic Arthritis Interested in Wellness Program, Although Barriers Remain

Shilpa Venkatachalam, PhD, MPH

Credit: Global Healthy Living Foundation

Most patients with psoriatic arthritis (PsA) showed interest in enrolling in a wellness program, with feeling better cited as a top motivator, according to data presented at the European Congress of Rheumatology (EULAR) 2023.¹ However, costs and a lack of energy to make changes to their routine were noted as the top barriers to adopting wellness behaviors. Investigators believe the results back the inclusion of guided online participation in similar programs, rather than online courses and written materials.

“Patients diagnosed PsA confront decisions about how to optimize treatment of their chronic disease including patient physician interaction and modifying their own lifestyle choices that may impact their disease outcomes,” wrote lead investigator W. Benjamin Nowell, PhD, Director, Patient-Centered Research and principal investigator of the ArthritisPower Research Registry, and colleagues.

A cross-sectional online survey was developed using patient and clinician input to assess the patient perspective of managing their disease using a guided online wellness program, including addressing lifestyle behaviors such as stress management, sleep, exercise, and nutrition. The survey was administered to patients living in the United States with a self-reported diagnosis of PsA who were enrolled in the ArthritisPower registry.

The questionnaire evaluated respondents experience with, as well as motivations to participate in, an online wellness program. Investigators used E-coaching, a validated tool which uses email coaching as a form of individualized communication on strategies aimed to improve lifestyle behaviors.

In total, 312 patients completed the survey. The mean age was 57.1 years, the mean time since PsA diagnosis was 10.0 years, and most patients were White (91.0%), female (83.0%), and were diagnosed by a rheumatologist for their PsA (93.6%).

More than 90% of respondents reported being “somewhat likely” or “very likely” to speak with an online coach ≥2 per week or spend 1 – 2 hours per week learning about sleep, nutrition, exercise, and stress management (90.4% and 92.6%, respectively) if given the opportunity. Despite this, only 8.7% of participants were currently enrolled in a structured wellness program.

Among the motivating factors for wellness program participation, feeling better was cited as the most common factor (n = 179, 57.4%), followed by the desire to improve PsA symptoms (n = 145, 46.5%). Regarding participation preferences, 34% (n = 106) of patients preferred to participate in the program by interacting with a trained profession in an online setting, 16.4% (n = 51) wanted to attend an online course, and 16.0% (n = 50) preferred reading written material.

The barriers to initiating wellness changes included cost (47.1%) and not having the energy to make changes (47.1%). Other barriers noted were not knowing what changes to make (34%) and not having time to make changes (14.4%). However, 13.1% of patients reported having no barriers regarding participation in wellness programs.

Previous studies evaluating mobile health and wellness programs have yielded positive results. A recent systematic review of randomized controlled trials (RCTs) showed that patients with chronic pain enrolled in a mobile health program reported improvements in both pain intensity and functional disability.²

“Successful treatment of any chronic disease, including psoriatic arthritis, requires a holistic approach that goes beyond diagnosis and taking medication,” stated Shilpa Venkatachalam, PhD, MPH, Director, Patient-Centered Research Operations and Ethical Oversight and co-principal investigator of ArthritisPower. “This study tells us that while PsA patients are willing to add wellness education and lifestyle adaptations to their disease management strategy, those programs need to be both accessible and affordable to optimize participation.”

Investigators noted future research should focus on how e-coaching wellness platforms can both improve and sustain these lifestyle changes in this patient population.

References

1. W B Nowell, A Degrassi, S Venkatachalam, K Gavigan, et al. Managing Psoriatic Arthritis: Patients’ Views and Attitudes to Using an Online Wellness Program. Paper presented at: European Congress of Rheumatology (EULAR) 2023. Milan, Italy. May 31 – June 3, 2023.
2. Pine, L. (2023a, January 5). Phase 2B data support AR882 for treatment of chronic gout. HCP Live. https://www.hcplive.com/view/phase-2b-data-support-ar882-for-treatment-of-chronic-gout