Patient involvement in rheumatoid arthritis care to improve disease activity-based management in daily practice: A randomized controlled trial

Objective: To evaluate the effect of an intervention to improve disease activity-based management of RA in daily clinical practice by addressing patient level barriers. Methods: The DAS-pass strategy aims to increase patients' knowledge about DAS28 and to empower patients to be involved in treatment (decisions). It consists of an informational leaflet, a patient held record and guidance by a specialized rheumatology nurse. In a Randomized Controlled Trial, 199 RA patients were randomized 1:1 to intervention or control group. Outcome measures were patient empowerment (EC-17; primary outcome), attitudes towards medication (BMQ), disease activity (DAS28) and knowledge about DAS28. Results: Our strategy did not affect EC-17, BMQ, or DAS28 use. However it demonstrated a significant improvement of knowledge about DAS28 in the intervention group, compared to the control group. The intervention had an additional effect on patients with low baseline knowledge compared to patients with high baseline knowledge. Conclusion: The DAS-pass strategy educates patients about (the importance of) disease activity-based management, especially patients with low baseline knowledge. Practice Implications: The strategy supports patient involvement in disease activity-based management of RA and can be helpful to reduce inequalities between patients in the ability to be involved in shared decision making. (C) 2021 The Authors. Published by Elsevier B.V.

Automated summary

This study evaluated the effectiveness of an intervention to improve disease activity-based management of rheumatoid arthritis (RA). The intervention, called DAS-pass strategy, aimed to increase patients' knowledge about disease activity and empower them to participate in treatment decisions. Although the intervention did not significantly affect patient empowerment, attitudes towards medication, or disease activity, it did lead to a significant improvement in knowledge about disease activity among the intervention group compared to the control group, particularly for patients with low baseline knowledge.