Pilot study assessing the novel use of musculoskeletal ultrasound in patients with rheumatoid arthritis to improve patient attitudes and adherence to medication

Autor: Samantha Joplin, Rick van der Zwan, Hanish Bagga, Peter K. K. Wong, Fred Joshua
Rok vydání: 2014
Předmět:
Adult
Male
medicine.medical_specialty
Health Knowledge
Attitudes
Practice
Time Factors
medicine.medical_treatment
Cost-Benefit Analysis
Pilot Projects
Musculoskeletal ultrasound
Physical function
Drug Costs
Medication Adherence
Arthritis
Rheumatoid
03 medical and health sciences
0302 clinical medicine
Rheumatology
Patient Education as Topic
Predictive Value of Tests
Surveys and Questionnaires
medicine
Humans
In patient
030212 general & internal medicine
Aged
Pain Measurement
030203 arthritis & rheumatology
Patient Activation Measure
Aged
80 and over
Analysis of Variance
Audiovisual Aids
business.industry
Immunosuppression
Ultrasonography
Doppler
Middle Aged
medicine.disease
Patient attitudes
Treatment Outcome
Rheumatoid arthritis
Antirheumatic Agents
Physical therapy
Visual Perception
Female
Joints
Analysis of variance
business
Immunosuppressive Agents
Zdroj: International journal of rheumatic diseases. 19(7)
ISSN: 1756-185X
Popis: Objective To determine if showing patients with rheumatoid arthritis (RA) ultrasound (US) images of their inflamed joints: (i) increased belief in the necessity of medication; (ii) encouraged patient activation, that is, confidence and understanding in managing their health; and (iii) facilitated medication adherence. Method Eighteen patients aged ≥ 18 years old with active RA (DAS28 [Disease Activity Score of 28 joints] > 2.6) requiring increased immunosuppression were included. The following questionnaires were administered at baseline (T1), 3 days post-US (T2) and 10 days post-US (T3): (i) Beliefs about Medicines Questionnaire (BMQ) to measure the cost-benefit analysis made by patients regarding the necessity versus concern of medication; (ii) Patient Activation Measure (PAM-13) to assess patient activation; (iii) Compliance Questionnaire-Rheumatology (CQR) to measure medication adherence; and (iv) Routine Assessment of Patient Index-3 (RAPID3) to assess physical function, pain and global status. US of ≥ 1 clinically affected joints was performed on one occasion with an explanation of findings. Results Patient cost-benefit decisions shifted positively following US, that is, favored belief in the necessity of medication with a mean ± SD cost-benefit ratio (possible range − 20 to + 20) at T1 of 1.17 ± 6.10 which increased to 2.54 ± 5.38 at T2 and 4.06 ± 5.76 at T3, P = 0.043 by analysis of variance (anova). PAM-13, CQR and RAPID3 scores remained stable (all P > 0.05 by anova). Conclusion Showing patients with RA ‘real-time’ US images of clinically inflamed joints resulted in a more favorable cost-benefit analysis, that is, increased patient belief in the necessity of medication versus concern about taking medication. There was no change in patient activation, medication adherence or disease severity.
Databáze: OpenAIRE
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