1
|
Plantinga LC, Xu G, Hoge C, Vandenberg A, Dunlop-Thomas C, Jones BD, Johnson J, Drenkard C, Lim SS, Bowling CB. Comprehension, Utility, and Acceptability of a Multidomain Physical Functioning Report for Systemic Lupus Erythematosus Patients and Their Providers. Arthritis Care Res (Hoboken) 2023; 75:180-189. [PMID: 34286926 PMCID: PMC8766603 DOI: 10.1002/acr.24756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 06/11/2021] [Accepted: 07/15/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Patient-provider discussions about functioning are often outside the scope of usual care for systemic lupus erythematosus (SLE), and tools to facilitate such discussions are lacking. The present study was undertaken to assess the comprehension, utility, and acceptability of a novel, individualized functioning report, the purpose of which is to facilitate patient-provider communication about functioning, in a predominantly Black SLE patient population. METHODS Individualized reports (including sections with pictorial representations of participants' measured activities of daily living, falls, physical performance, perceived physical functioning, and community mobility from a previous pilot study visit) and surveys were emailed or mailed to 59 SLE patients. Ease of interpretation was dichotomized ("very easy" versus all other responses). Utility and acceptability were assessed by items relating to usefulness for care planning and comfort with discussing the report. RESULTS Among 47 (79.7%) SLE patients who completed the survey (78.7% Black, 91.5% female, mean age 49.6 years), the reported ease of interpretation ranged from 70.2% to 85.1% across the report sections. Ease of interpretation was lower among those who were older, Black, and female and who had lower cognitive scores (P > 0.05 for all). Most reported that physical functioning domains of the report were useful for treatment or other care planning (70.2-80.5%) and that they felt comfortable discussing the report with a health care provider (93.2-100%). CONCLUSION We found that a novel functioning report for SLE patients was associated with high comprehension, utility, and acceptability. Future studies can help determine how an individualized functioning report could improve patient-provider communication in the clinic setting.
Collapse
Affiliation(s)
| | - Grace Xu
- Emory University, Atlanta, Georgia
| | | | | | | | | | | | | | | | - C Barrett Bowling
- Durham Veterans Affairs Health System and Duke University, Durham, North Carolina
| |
Collapse
|
2
|
Plantinga L, Vandenberg A, Goldstein F, Jones B, Johnson J, Bowling CB, Dunlop-Thomas C, Lim SS, Drenkard C. Patient and provider perceptions of a novel cognitive functioning report for patients with systemic lupus erythematosus: a qualitative study. Lupus Sci Med 2021; 8:8/1/e000476. [PMID: 33627441 PMCID: PMC7908286 DOI: 10.1136/lupus-2021-000476] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 02/04/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To determine whether and how cognitive assessment data should be included in a report for patients with SLE and their providers. METHODS Leveraging experiences from prior studies, we created a cognitive report that included a hypothetical patient's results on tests of multiple domains based on the NIH Toolbox Fluid Cognition Battery. In focus groups that comprised patients with SLE (two groups) and their providers (two groups), feedback was sought on the presentation of results as well as the potential value of the report in the clinical setting. RESULTS Feedback regarding the presentation of the report was generally positive. Both patients with SLE and their providers liked its simple graphics and use of a colour-gradated scale to indicate performance. However, both groups stressed the importance of using non-stigmatising language in describing results. Several potential purposes of the report, including distinguishing cognitive versus other issues, explaining cognitive challenges, improving patient-provider interactions, guiding decision-making, improving functioning or preventing impairment and tracking cognitive function over time, were noted by the participants. Potential barriers, such as inadequate clinical staffing or time and lack of potential treatments for identified issues, were also discussed. CONCLUSION In this exploratory study, we found that both patients with SLE and their providers were receptive to the idea of a patient-friendly report of cognitive test results. This study provides important information to guide future pragmatic research to optimise the delivery of cognitive information to patients with SLE.
Collapse
Affiliation(s)
- Laura Plantinga
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA .,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Ann Vandenberg
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Felicia Goldstein
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Brian Jones
- Interactive Media Techology Center, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Jeremy Johnson
- Interactive Media Techology Center, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Christopher Barrett Bowling
- Durham Veterans Affairs Geriatric Research Education and Clinical Center, Durham Veterans Affairs Medical Center, Durham, NC, USA.,Department of Medicine, Duke University, Durham, NC, USA
| | | | - Sung Sam Lim
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Cristina Drenkard
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| |
Collapse
|