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Greene GJ, Beaumont JL, Bacalao EJ, Muftic A, Kaiser K, Eisenstein A, Mandelin AM, Cella D, Ruderman EM. Integrating PROMIS Measures in a Treat to Target (T2T) Approach to Standardize Patient-Centered Treatment of Rheumatoid Arthritis. J Rheumatol 2023:jrheum.2022-1176. [PMID: 37127317 DOI: 10.3899/jrheum.2022-1176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate the impact of a patient-centered rheumatoid arthritis (RA) treat to target (T2T) disease management approach on patient outcomes and patient satisfaction with care. METHODS In this longitudinal, observational pilot study, rheumatologists implemented a modified T2T approach that integrated PROMIS measures for depression, fatigue, pain interference, physical function, and social function into RA care. Study participants selected one PROMIS domain to target treatment and completed quarterly follow-up assessments. Participants were classified as improved if their Clinical Disease Activity Index (CDAI) changed by > 5 points. Change in PROMIS T-scores was examined for the group with improved CDAI, compared to those with unchanged or worsened CDAI. Satisfaction with care was assessed using multiple measures, including the FACIT Treatment Satisfaction - Patient Satisfaction Scale. RESULTS The analytic sample (N = 119, median age = 57 years, 90.8% female) was split between those with CDAI > 10 (n = 63) and CDAI ≤ 10 (n = 53). At 1 year, there was improvement in CDAI by > 5 points in 66% and 13% of individuals with baseline CDAI > 10 and baseline CDAI ≤ 10, respectively. Across all participants, improvement in CDAI by > 5 points correlated with improvements in the five PROMIS domains. Satisfaction with RA treatment also increased. CONCLUSION The integration of PROMIS measures into the T2T approach for RA care was associated with improvements in disease activity, and improvement in disease activity was associated with improvements in PROMIS measures.
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Affiliation(s)
- George J Greene
- George J. Greene, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jennifer L Beaumont
- Jennifer L. Beaumont, MS, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Clinical Outcomes Solutions, Tucson AZ USA
| | - Emily J Bacalao
- Emily J. Bacalao, BS, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Azra Muftic
- Azra Muftic, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Karen Kaiser
- Karen Kaiser, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Amy Eisenstein
- Amy Eisenstein, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Arthur M Mandelin
- Arthur M. Mandelin, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David Cella
- David Cella, PhD, Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Eric M Ruderman
- Eric M. Ruderman, MD, Department of Medicine, Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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