Rheumatoid Arthritis Shared Decision Making

Summary

Shared decision making is the first overarching principle for the treat to target guidelines for rheumatoid arthritis (RA) and has been proposed as a potential mechanism to reduce health disparities, however there is little evidence to inform effective ways to implement this practice in the care of Veterans with RA. The purpose of this project is to evaluate the effectiveness of a multi-component shared decision making intervention on RA disease activity, adherence to RA medications and patient knowledge of RA. The proposed research will contribute to fundamental knowledge about how to effectively foster shared decision making across varied VA rheumatology clinical settings to improve patient disease outcomes and experience; and support clinicians to engage patients in meaningful ways with the ultimate goal to improve health, reduce disability, and eliminate disparities.

Eligibility

Inclusion Criteria:

Inclusion criteria for patient participants (Aims 1 \& 2):

* Meet administrative data definition of rheumatoid arthritis (see recruitment section)
* Receive rheumatology outpatient care at participating clinics and seen at least once in prior 12 months
* Age 18 years or older
* English speaking
* Moderate to high RA disease activity within 18 months prior to enrollment

Inclusion criteria for professional participants (Aims 1-3):

-Rheumatology attendings, fellows or advanced practice partners (nurse practitioners or physicians assistants) at the respective clinics

Inclusion criteria for non-clinician participants (Aim 3):

* Have held a leadership position within their respective institution for minimum of 12 months prior to enrollment
* Have worked in the rheumatology clinic setting at their respective institution for minimum of 12 months prior

Exclusion Criteria:

Exclusion criteria for patient participants (Aims 1 \& 2):

* Cognitive impairment
* Inability to speak

Exclusion criteria for professional participants (Aims 1-3):

-none

Exclusion criteria for non-clinician participants (Aim 3):

* Have held a leadership position within their respective institution for \<12 months
* Have worked in a clinic setting other than rheumatology
* Have worked in a clinic setting \<12 months

Conditions2

Locations4 sites

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