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Thomas M, Barnabe C, Kleissen T, Lacaille D, Hazlewood G, Fifi-Mah A, Hassen N, Henry R, Kuluva M, English K, Koehn C, Lane T, Johnson N. Rheumatoid Arthritis Care Experiences of Black People Living in Canada: A Qualitative Study to Inform Health Service Improvements. Arthritis Care Res (Hoboken) 2024; 76:470-485. [PMID: 38073024 DOI: 10.1002/acr.25278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 11/20/2023] [Accepted: 12/05/2023] [Indexed: 01/28/2024]
Abstract
OBJECTIVE To understand experiences related to rheumatoid arthritis (RA) care and propose service-level strategies to reduce and mitigate inequities for Black people living in Canada. METHODS Purposive and respondent driven sampling was used to recruit participants for qualitative interviews to explore population factors relevant to RA care and challenges and facilitators for access to health care services, medications, and enacting preferred treatment plans. Thematic analysis was conducted using the Braun and Clarke method with inductive and deductive coding and critical race theory guiding analysis. RESULTS Six women and two men with RA, and two women health care professionals, expressed how their racial identity contributed to their understanding of RA, preferences for treatment, and outcome goals. Health care access was influenced by financial limitations and racism, by exclusion, and discrimination, and also by cultural norms in seeking health care and awareness about RA within the Black community. Participants experienced health system fragmentation and were not connected to ancillary supports. Treatment decision-making was influenced by the legacy of oppression and medical experimentation on Black people and the predominance of biomedical approaches emphasized by health care providers. Holistic and cultural approaches, provided in safe, trauma-informed care environments, with flexibility in service models, are desired. Partnerships between arthritis care services and Black community organizations are proposed to promote community awareness and knowledge about arthritis and provide support mechanisms for patients within their community. CONCLUSION Our study highlights unique considerations based on race and ethnicity and provides suggestions for arthritis care to mitigate inequities for Black people living with arthritis.
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Affiliation(s)
- Megan Thomas
- University of Calgary, Calgary, Alberta, Canada, and The University of British Columbia and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Cheryl Barnabe
- University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Diane Lacaille
- Arthritis Research Canada and The University of British Columbia, Vancouver, Brtish Columbia, Canada
| | - Glen Hazlewood
- University of Calgary, Calgary, Alberta, Canada, and Arthritis Research Canada, Vancouver, British Columbia, Canada
| | | | - Nejat Hassen
- Arthritis Research Canada and The University of British Columbia, Vancouver, Brtish Columbia, Canada
| | - Richard Henry
- Jewish General Hospital and McGill University, Montreal, Quebec, Canada
| | | | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Therese Lane
- Canadian Arthritis Patient Alliance, Ottawa, Ontario, Canada
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Saraux A, da Mota LMH, Dixit S, Gibofsky A, Matsubara T, Mulvey A, Koehn C, Mortezavi M, Segovia M, Kessouri M. Impact of the COVID-19 Pandemic on People Living with Rheumatoid Arthritis: Experiences and Preferences in Accessing Healthcare Across Five Countries. Rheumatol Ther 2024; 11:257-268. [PMID: 38217796 PMCID: PMC10920583 DOI: 10.1007/s40744-023-00629-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/24/2023] [Indexed: 01/15/2024] Open
Abstract
INTRODUCTION The global coronavirus 2019 (COVID-19) pandemic created many challenges in healthcare provision. This study aimed to evaluate the global impact of the COVID-19 pandemic on people living with rheumatoid arthritis (RA). METHODS The RA Narrative COVID-19 survey was conducted online among people with RA who resided in Brazil, Canada, France, Japan, and the US from August to September 2021. The survey examined disease management, healthcare access and experiences, and participant preferences for interactions with their doctor. RESULTS Overall, 500 participants completed the survey: 100 each resided in Brazil, Canada, France, Japan, and the US. Emotional well-being was the aspect of disease management most reported to be negatively impacted by the pandemic (55% of participants); 'having more anxiety and/or stress' during the pandemic was the top factor that made controlling RA symptoms more difficult (49% of participants). In comparison, the top factor that made controlling RA symptoms easier was 'having a less busy schedule' (35% of participants). More participants had virtual appointments during versus pre-pandemic (53% vs. 13%, respectively) and participants were equally satisfied with the overall quality of care received via virtual and in-person appointments (76% of participants were 'satisfied' or 'very satisfied' with both). However, participants generally preferred in-person over virtual appointments, except for prescription refills, for which preferences were similar (39% vs. 36%, respectively). CONCLUSIONS This survey suggests that the COVID-19 pandemic did negatively impact some aspects of disease management for people living with RA but had positive impacts on the utilization of virtual care. Although participants generally preferred in-person appointments, these results position virtual care as an appropriate means for routine follow-ups.
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Affiliation(s)
- Alain Saraux
- Rheumatology Unit, University Hospital, Hôpital de La Cavale Blanche, Brest, France
| | - Licia Maria Henrique da Mota
- Unidade de Reumatologia, Universidade de Brasília, Brasília, Brazil
- Programa de Pós-Graduação em Ciências Médicas, Faculdade de Medicina, Universidade de Brasília, Brasília, Brazil
| | - Sanjay Dixit
- Division of Rheumatology, McMaster University, Hamilton, ON, Canada
| | - Allan Gibofsky
- Department of Medicine, Hospital for Special Surgery-Weill Cornell Medicine, New York, NY, USA
| | - Tsukasa Matsubara
- Department of Orthopaedic Surgery, Matsubara Mayflower Hospital, Kato, Japan
| | | | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | | | | | - Meriem Kessouri
- Pfizer France, 23-25 Avenue du Dr Lannelongue, 75668, Paris, France.
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Alnaqbi KA, Bellanger A, Brill A, Castañeda-Hernández G, Clopés Estela A, Delgado Sánchez O, García-Alfonso P, Gyger P, Heinrich D, Hezard G, Kakehasi A, Koehn C, Mariotte O, Mennini F, Mayra Pérez-Tapia S, Pistollato M, Saada R, Sasaki T, Tambassis G, Thill M, Werutsky G, Wilsdon T, Simoens S. An international comparative analysis and roadmap to sustainable biosimilar markets. Front Pharmacol 2023; 14:1188368. [PMID: 37693908 PMCID: PMC10484585 DOI: 10.3389/fphar.2023.1188368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 06/22/2023] [Indexed: 09/12/2023] Open
Abstract
Background: Although biosimilar uptake has increased (at a variable pace) in many countries, there have been recent concerns about the long-term sustainability of biosimilar markets. The aim of this manuscript is to assess the sustainability of policies across the biosimilar life cycle in selected countries with a view to propose recommendations for supporting biosimilar sustainability. Methods: The study conducted a comparative analysis across 17 countries from North America, South America, Asia-Pacific, Europe and the Gulf Cooperation Council. Biosimilar policies were identified and their sustainability was assessed based on country-specific reviews of the scientific and grey literature, validation by industry experts and 23 international and local non-industry experts, and two advisory board meetings with these non-industry experts. Results: Given that European countries tend to have more experience with biosimilars and more developed policy frameworks, they generally have higher sustainability scores than the other selected countries. Existing approaches to biosimilar manufacturing and R&D, policies guaranteeing safe and high-quality biosimilars, exemption from the requirement to apply health technology assessment to biosimilars, and initiatives counteracting biosimilar misconceptions are considered sustainable. However, biosimilar contracting approaches, biosimilar education and understanding can be ameliorated in all selected countries. Also, similar policies are sometimes perceived to be sustainable in some markets, but not in others. More generally, the sustainability of the biosimilar landscape depends on the nature of the healthcare system and existing pharmaceutical market access policies, the experience with biosimilar use and policies. This suggests that a general biosimilar policy toolkit that ensures sustainability does not exist, but varies from country to country. Conclusion: This study proposes a set of elements that should underpin sustainable biosimilar policy development over time in a country. At first, biosimilar policies should guarantee the safety and quality of biosimilars, healthy levels of supply and a level of cost savings. As a country gains experience with biosimilars, policies need to optimise uptake and combat any misconceptions about biosimilars. Finally, a country should implement biosimilar policies that foster competition, expand treatment options and ensure a sustainable market environment.
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Affiliation(s)
- Khalid A. Alnaqbi
- Tawam Hospital, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates
| | - Agnès Bellanger
- Pitié Salpétrière Hospital, Sorbonne University, Paris, France
| | - Alex Brill
- Matrix Global Advisors, American Enterprise Institute, Washington, DC, United States
| | | | | | | | - Pilar García-Alfonso
- Medical Oncology Department, Gregorio Marañón General University Hospital, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense, Madrid, Spain
| | - Pius Gyger
- Independent Consultant, Zurich, Switzerland
| | | | | | - Adriana Kakehasi
- Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | | | - Francesco Mennini
- Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome “Tor Vergata”, Rome, Italy
| | - Sonia Mayra Pérez-Tapia
- Unidad de Investigacion, Desarollo e Innovacion Médica y Biotecnológica (UDIMEB), Unidad de Desarollo e Investigacion de Bioterapeuticos (UDIBI), Instituto Politécnico Nacional, Ciudad de México, Mexico
| | | | - Rowan Saada
- Charles River Associates, London, United Kingdom
| | | | | | - Marc Thill
- Department of Gynecology and Gynecological Oncology, Agaplesion Markus Hospital, Frankfurt, Germany
| | | | - Tim Wilsdon
- Charles River Associates, London, United Kingdom
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4
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Lunny C, Zarin W, Chaudhry S, Thomas SM, LeBlanc A, Desroches S, Horsley T, Colquhoun H, Sanon PN, Downey M, Goodarzi Z, Baxter NN, English K, PausJenssen E, McQuitty S, Wilhelm L, McKinnon A, Hoens AM, Li LC, Clement F, Curran JA, Abou-Setta AM, Godfrey C, Moher D, Moffitt P, Walker J, Jull J, Koehn C, Isaranuwatchai W, Straus SE, Tricco AC. An inclusive and diverse governance structure of the strategy for patient-oriented research (SPOR) Evidence Alliance. Facets (Ott) 2022. [DOI: 10.1139/facets-2021-0129] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to ( i) outline the governance and committee structure of the SPOR Evidence Alliance, ( ii) outline the procedures for patient and health system decision-maker engagement, and ( iii) present the capacity-building strategy for governance members. The governance structure includes the following six standing committees: the International Advisory Committee, Steering Committee, Executive Committee, Knowledge Translation Committee, Partnerships Committee, and Training and Capacity Development Committee. The guiding principles embrace inclusiveness, support, mutual respect, transparency, and co-building. There are currently 64 committee members across the six committees, 13 patient and public partners, 8 health system decision-makers, 7 research trainees, and 36 researchers. A multi-disciplinary and diverse group of people in Canada are represented from all regions and at various levels of training in knowledge generation, exchange, and translation. This collaborative model makes the SPOR Evidence Alliance strong and sustainable by leveraging the knowledge, lived experiences, expertise, skills, and networks among its 342 members and 12 principal investigators.
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Affiliation(s)
- Carole Lunny
- Cochrane Hypertension Review Group, Therapeutics Initiative, Department of Anesthesiology, Pharmacology & Therapeutics, Faculty of Medicine, University of British Columbia, 2176 Health Science Mall, Vancouver, BC V6T 1Z3, Canada
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Wasifa Zarin
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Sabrina Chaudhry
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Sonia M. Thomas
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Annie LeBlanc
- VITAM Research Center on Sustainable Health, CIUSSS de la Capitale Nationale, Quebec City, QC G1J 0A4, Canada
- Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, Quebec City, QC G1V 0A6, Canada
| | - Sophie Desroches
- School of Nutrition, Université Laval, Centre Nutrition, santé et société (NUTRISS), Institute of Nutrition and Functional Foods (INAF), Université Laval, 2440 Blvd Hochelaga, Quebec City, QC G1V 0A6, Canada
| | - Tanya Horsley
- Research Unit, Royal College of Physicians and Surgeons of Canada, 774 Echo Drive, Ottawa, ON K1S 5N8, Canada
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - Heather Colquhoun
- Department of Occupational Science & Occupational Therapy, University of Toronto, 500 University Ave, Toronto, ON M5G 1V7, Canada
| | - Priscille-Nice Sanon
- Sickle Cell Anemia Association of Quebec, 333, Saint-Denis Street, office 3, Montréal, QC H2R 2E5, Canada
| | - Minnie Downey
- BC SUPPORT Unit, Suite 420, 1367 West Broadway, Vancouver, BC V6H 4A7, Canada
| | - Zahra Goodarzi
- Department of Medicine and Community Health Sciences, Hotchkiss Brain Institute and O’Brien Institute of Public Health, University of Calgary, 2500 University Drive NW, Calgary, AB T2N 1N4, Canada
| | - Nancy N. Baxter
- Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Melbourne, VIC 3053, Australia
| | - Kelly English
- Arthritis Patients Advisory Board, 5591 No. 3 Rd., Richmond, BC V6X 2C7, Canada
| | - Elliot PausJenssen
- Saskatoon Council on Aging, 2020 College Dr, Saskatoon, SK S7N 2W4, Canada
| | - Shanon McQuitty
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | | | | | - Alison M. Hoens
- BC SUPPORT Unit, Suite 420, 1367 West Broadway, Vancouver, BC V6H 4A7, Canada
- Arthritis Patient Advisory Board of Arthritis Research Canada, 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
- Arthritis Research Canada, 230 – 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Linda C. Li
- Department of Physical Therapy, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC V6T 1Z3, Canada
- Arthritis Research Canada, 230 – 2238 Yukon Street, Vancouver, BC V5Y 3P2, Canada
| | - Fiona Clement
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, 3280 Hospital Dr NW, Calgary, AB T2N 4N6, Canada
| | - Janet A. Curran
- School of Nursing, Faculty of Health, Dalhousie University, 5869 University Ave, Halifax, NS B3H 4R2, Canada
| | - Ahmed M. Abou-Setta
- George & Fay Yee Centre for Healthcare Innovation, Rady Faculty of Health Sciences, University of Manitoba, 367-753 McDermot Ave, Winnipeg, MB R3E 0T6, Canada
| | - Christina Godfrey
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, 92 Barrie Street, Kingston, ON K7L 3J8, Canada
| | - David Moher
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, 451 Smyth Rd, Ottawa, ON K1H 8M5, Canada
| | - Pertice Moffitt
- North Slave Research Centre, Aurora College, Bag 9700, 5004-54th St, Yellowknife, NT X1A 2R3, Canada
| | - Jennifer Walker
- Associate Professor, Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University
| | - Janet Jull
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, 31 George Street, Kingston, ON K7L 3N6, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, 1529 West 6th Ave, Vancouver, BC V6J 1R1, Canada
| | - Wanrudee Isaranuwatchai
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
| | - Sharon E. Straus
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
| | - Andrea C. Tricco
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Unity Health Toronto, 209 Victoria Street, East Building, Toronto, ON M5B 1T8, Canada
- Queen’s Collaboration for Health Care Quality: A JBI Centre of Excellence, Queen’s University School of Nursing, 92 Barrie Street, Kingston, ON K7L 3J8, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON M5T 3M7, Canada
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5
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Leese J, Backman CL, Ma JK, Koehn C, Hoens AM, English K, Davidson E, McQuitty S, Gavin J, Adams J, Therrien S, Li LC. Experiences of self-care during the COVID-19 pandemic among individuals with rheumatoid arthritis: A qualitative study. Health Expect 2021; 25:482-498. [PMID: 34403189 PMCID: PMC8444741 DOI: 10.1111/hex.13341] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/06/2021] [Accepted: 07/21/2021] [Indexed: 12/17/2022] Open
Abstract
Objectives This study aimed to explore the impact of the coronavirus disease 2019 (COVID‐19) pandemic on self‐care of individuals living with rheumatoid arthritis (RA). Methods Guided by a constructivist, qualitative design, we conducted one‐to‐one in‐depth telephone interviews between March and October 2020 with participants with RA purposively sampled for maximum variation in age, sex and education, who were participating in one of two ongoing randomized‐controlled trials. An inductive, reflexive thematic analysis approach was used. Results Twenty‐six participants (aged 27–73 years; 23 females) in British Columbia, Canada were interviewed. We identified three themes: (1) Adapting to maintain self‐care describes how participants took measures to continue self‐care activities while preventing virus transmissions. While spending more time at home, some participants reported improved self‐care. (2) Managing emotions describes resilience‐building strategies such as keeping perspective, positive reframing and avoiding negative thoughts. Participants described both letting go and maintaining a sense of control to accommodate difficulties and emotional responses. (3) Changing communication with health professionals outlined positive experiences of remote consultations with health professionals, particularly if good relationships had been established prepandemic. Conclusion The insights gained may inform clinicians and researchers on ways to support the self‐care strategies of individuals with RA and other chronic illnesses during and after the COVID‐19 pandemic. The findings reveal opportunities to further examine remote consultations to optimize patient engagement and care. Patient or Public Contribution This project is jointly designed and conducted with patient partners in British Columbia, Canada. Patient partners across the United Kingdom also played in a key role in providing interpretations of themes during data analysis.
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Affiliation(s)
- Jenny Leese
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Vancouver, British Columbia, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jasmin K Ma
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, British Columbia, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Kelly English
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Eileen Davidson
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - Shanon McQuitty
- Arthritis Research Canada, Vancouver, British Columbia, Canada
| | - James Gavin
- School of Health Sciences, University of Southampton, Southampton, UK
| | - Jo Adams
- School of Health Sciences, University of Southampton, Southampton, UK
| | | | - Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.,Arthritis Research Canada, Vancouver, British Columbia, Canada
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Li LC, Feehan LM, Xie H, Lu N, Shaw C, Gromala D, Aviña‐Zubieta JA, Koehn C, Hoens AM, English K, Tam J, Therrien S, Townsend AF, Noonan G, Backman CL. Efficacy of a Physical Activity Counseling Program With Use of a Wearable Tracker in People With Inflammatory Arthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken) 2020; 72:1755-1765. [DOI: 10.1002/acr.24199] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 03/24/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Linda C. Li
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Lynne M. Feehan
- University of British Columbia Vancouver British Columbia Canada
| | - Hui Xie
- Arthritis Research Canada, Richmond, and Simon Fraser University Burnaby British Columbia Canada
| | - Na Lu
- Arthritis Research Canada, Richmond, and Simon Fraser University Burnaby British Columbia Canada
| | - Chris Shaw
- Simon Fraser University Surrey British Columbia Canada
| | - Diane Gromala
- Simon Fraser University Surrey British Columbia Canada
| | - J. Antonio Aviña‐Zubieta
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts Vancouver British Columbia Canada
| | - Alison M. Hoens
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
| | - Kelly English
- Arthritis Research Canada Richmond British Columbia Canada
| | - Johnathan Tam
- Arthritis Research Canada Richmond British Columbia Canada
| | | | | | - Greg Noonan
- Vancouver General Hospital Vancouver British Columbia Canada
| | - Catherine L. Backman
- University of British Columbia, Vancouver, and Arthritis Research Canada Richmond British Columbia Canada
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7
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Li LC, Feehan LM, Xie H, Lu N, Shaw CD, Gromala D, Zhu S, Aviña-Zubieta JA, Hoens AM, Koehn C, Tam J, Therrien S, Townsend AF, Noonan G, Backman CL. Effects of a 12-Week Multifaceted Wearable-Based Program for People With Knee Osteoarthritis: Randomized Controlled Trial. JMIR Mhealth Uhealth 2020; 8:e19116. [PMID: 32618578 PMCID: PMC7367519 DOI: 10.2196/19116] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 05/01/2020] [Accepted: 06/03/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Current guidelines emphasize an active lifestyle in the management of knee osteoarthritis (OA), but up to 90% of patients with OA are inactive. In a previous study, we demonstrated that an 8-week physiotherapist (PT)-led counseling intervention, with the use of a Fitbit, improved step count and quality of life in patients with knee OA, compared with a control. OBJECTIVE This study aimed to examine the effect of a 12-week, multifaceted wearable-based program on physical activity and patient outcomes in patients with knee OA. METHODS This was a randomized controlled trial with a delay-control design. The immediate group (IG) received group education, a Fitbit, access to FitViz (a Fitbit-compatible app), and 4 biweekly phone calls from a PT over 8 weeks. Participants then continued using Fitbit and FitViz independently up to week 12. The delay group (DG) received a monthly electronic newsletter in weeks 1 to 12 and started the same intervention in week 14. Participants were assessed in weeks 13, 26, and 39. The primary outcome was time spent in daily moderate-to-vigorous physical activity (MVPA; in bouts ≥10 min) measured with a SenseWear Mini. Secondary outcomes included daily steps, time spent in purposeful activity and sedentary behavior, Knee Injury and OA Outcome Score, Patient Health Questionnaire-9, Partners in Health Scale, Theory of Planned Behavior Questionnaire, and Self-Reported Habit Index. RESULTS We enrolled 51 participants (IG: n=26 and DG: n=25). Compared with the IG, the DG accumulated significantly more MVPA time at baseline. The adjusted mean difference in MVPA was 13.1 min per day (95% CI 1.6 to 24.5). A significant effect was also found in the adjusted mean difference in perceived sitting habit at work (0.7; 95% CI 0.2 to 1.2) and during leisure activities (0.7; 95% CI 0.2 to 1.2). No significant effect was found in the remaining secondary outcomes. CONCLUSIONS A 12-week multifaceted program with the use of a wearable device, an app, and PT counseling improved physical activity in people with knee OA. TRIAL REGISTRATION ClinicalTrials.gov NCT02585323; https://clinicaltrials.gov/ct2/show/NCT02585323.
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Affiliation(s)
- Linda C Li
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Lynne M Feehan
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Hui Xie
- Arthritis Research Canada, Richmond, BC, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Na Lu
- Arthritis Research Canada, Richmond, BC, Canada
| | - Christopher D Shaw
- School of Interactive Art & Technology, Simon Fraser University, Burnaby, BC, Canada
| | - Diane Gromala
- School of Interactive Art & Technology, Simon Fraser University, Burnaby, BC, Canada
| | - Siyi Zhu
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
- Rehabilitation Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - J Antonio Aviña-Zubieta
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Alison M Hoens
- Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
- Arthritis Research Canada, Richmond, BC, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | | | | | - Anne F Townsend
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancashire, United Kingdom
| | - Gregory Noonan
- Mary Pack Arthritis Program, Vancouver General Hospital, Vancouver, BC, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, BC, Canada
- Department of Occupational Science & Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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Kaal KJ, Bansback N, Hudson M, Anis A, Koehn C, Harrison M. Patient-provider communication about medication cost in rheumatoid arthritis. Clin Rheumatol 2020; 40:93-100. [PMID: 32506315 DOI: 10.1007/s10067-020-05188-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine the perceived importance and frequency with which out-of-pocket medication costs are discussed between rheumatologists and patients with rheumatoid arthritis (RA) in Canada. METHODS A cross-sectional online survey was distributed to patients with RA and rheumatologists; both were asked to rate their perceived importance of discussing medication costs, and how often these discussions occurred. Predictors of (1) patients discussing costs with their rheumatologist and (2) the perceived importance of discussing medication cost for patients were explored. RESULTS Seventy-eight patients and 64 rheumatologists completed the survey; 68% patients and 75% of physicians rated the perceived importance of discussing medication costs as "quite" or "very important"; 22% of patients reported never talking about medication cost, but no physicians reported never discussing costs with patients. The only predictor of talking about cost among patients (at 10% level) was whether they perceived it as highly important (p = 0.058). Higher perceived importance of discussing out-of-pocket costs was associated with a more positive attitude to shared decision-making (p = 0.044). CONCLUSION Discussions about cost do not always happen, even with diseases with potentially high medication costs like RA. Cost was more likely to be discussed by patients who perceived it as "very important," suggesting the onus might be on patients to initiate these conversations. Without any significant predictors regarding what may make physicians more likely to think it was important to discuss medication costs, there is a need to reinforce recommendations that all physicians seek to discuss costs with all of their patients when suggesting medications. Key Points • There is a need for patients and physicians to discuss costs in the treatment decision-making process. Our findings suggest this does not always happen. • Among patients, medication cost was more likely to be discussed by those who perceived it as "very important" and higher perceived importance of discussing out-of-pocket costs was associated with a more positive attitude to shared decision-making. • Our results did not reveal any significant predictors regarding what may make physicians more likely to think it was important to discuss medication costs, suggesting that there is a need to reinforce recommendations that all physicians seek to discuss medication costs with all of their patients when suggesting medications.
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Affiliation(s)
- K Julia Kaal
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Nick Bansback
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,St. Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada
| | - Marie Hudson
- Division of Rheumatology, Jewish General Hospital and Lady Davis Institute, and Department of Medicine, McGill University, Montreal, QC, Canada
| | - Aslam Anis
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.,St. Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts/JointHealth, Vancouver, Canada
| | - Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada. .,St. Paul's Hospital, 1081 Burrard St, Vancouver, BC, V6Z 1Y6, Canada. .,Arthritis Research Canada, Richmond, Canada.
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9
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Harrison M, Spooner L, Bansback N, Milbers K, Koehn C, Shojania K, Finckh A, Hudson M. Preventing rheumatoid arthritis: Preferences for and predicted uptake of preventive treatments among high risk individuals. PLoS One 2019; 14:e0216075. [PMID: 31022252 PMCID: PMC6483264 DOI: 10.1371/journal.pone.0216075] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 04/14/2019] [Indexed: 01/16/2023] Open
Abstract
OBJECTIVE To understand preferences for and estimate the likely uptake of preventive treatments currently being evaluated in randomized controlled trials with individuals at increased risk of developing rheumatoid arthritis (RA). METHODS Focus groups were used to identify key attributes of potential preventive treatment for RA (reduction in risk of RA, how treatment is taken, chance of side effects, certainty in estimates, health care providers opinion). A web-based discrete choice experiment (DCE) was administered to people at-risk of developing RA, asking them to first choose their preferred of two hypothetical preventive RA treatments, and then between their preferred treatment and 'no treatment for now.' DCE data was analyzed using conditional logit regression to estimate the significance and relative importance of attributes in influencing preferences. RESULTS Two-hundred and eighty-eight first-degree relatives (60% female; 66% aged 18-39 years) completed all tasks in the survey. Fourteen out of fifteen attribute levels significantly influenced preferences for treatments. How treatment is taken (oral vs. infusion β0.983, p<0.001), increasing reduction in risk of RA (β0.922, p<0.001), health care professional preference (β0.900, p<0.001), and avoiding irreversible (β0.839, p<0.001) or reversible serious side effects (β0.799, p<0.001) were most influential. Predicted uptake was high for non-biologic drugs (e.g. 84% hydroxycholoroquine), but very low for atorvastatin (8%) and biologics (<6%). CONCLUSION Decisions to take preventative treatments are complex, and uptake depends on how treatments can compromise on convenience, potential risks and benefits, and recommendations/preferences of health care professionals. This evidence contributes to understanding whether different preventative treatment strategies are likely to be acceptable to target populations.
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Affiliation(s)
- Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
- Arthritis Research Canada, Richmond, Canada
| | - Luke Spooner
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - Nick Bansback
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
- Arthritis Research Canada, Richmond, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Katherine Milbers
- Centre for Health Evaluation and Outcome Sciences, St. Paul’s Hospital, Vancouver, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts/JointHealth, Vancouver, Canada
| | - Kam Shojania
- Arthritis Research Canada, Richmond, Canada
- Division of Rheumatology, University of British Columbia, Vancouver, Canada
| | - Axel Finckh
- Division of Rheumatology, University of Geneva, Geneva, Switzerland
| | - Marie Hudson
- Division of Rheumatology, Jewish General Hospital and Lady Davis Institute, and Department of Medicine, McGill University, Montreal, Canada
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10
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Macdonald GG, Koehn C, Attara G, Stordy A, Allerdings M, Leese J, Li LC, Backman CL. Patient Perspectives on the Challenges and Responsibilities of Living With Chronic Inflammatory Diseases: Qualitative Study. J Particip Med 2018; 10:e10815. [PMID: 33052129 PMCID: PMC7434083 DOI: 10.2196/10815] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/28/2018] [Accepted: 09/09/2018] [Indexed: 01/14/2023] Open
Abstract
Background Collectively, chronic inflammatory diseases take a great toll on individuals and society in terms of participation restrictions, quality of life, and economic costs. Although prior qualitative studies have reported patients’ experiences and challenges living with specific diseases, few have compared the consequences of disease management in daily life across different types of inflammatory diseases in studies led by patient partners. Objective The aim of this study was to identify the significant consequences of inflammatory arthritis, psoriasis, and inflammatory bowel diseases on daily life and explore commonalities across diseases. Methods A cross-sectional Web-based survey was designed by patient research partners and distributed by patient awareness organizations via their social media channels and by sharing a link in a newspaper story. One open-ended item asked about burdens and responsibilities experienced in daily life. Informed by narrative traditions in qualitative health research, we applied a thematic content analysis to participants’ written accounts in response to this item. This is an example of a study conceived, conducted, and interpreted with patients as research partners. Results A total of 636 Canadians, with a median age band of 55-64 years, submitted surveys, and 80% of the respondents were women. Moreover, 540 participants provided written substantive responses to the open-ended item. Overall, 4 main narratives were generated: (1) daily life disrupted; (2) socioeconomic vulnerabilities; (3) stresses around visible, invisible, and hiding disabilities; and (4) actions aimed at staying positive. Ways in which participants experienced social stigma, pain and fatigue, balancing responsibilities, and worries about the future appeared throughout all 4 narratives. Conclusions People living with chronic inflammatory diseases affecting joints, skin, and the digestive tract report important gaps between health, social, and economic support systems that create barriers to finding the services they need to sustain their health. Regardless of diagnosis, they report similar experiences navigating the consequences of lifelong conditions, which have implications for policy makers. There is a need for outcome measures in research and service delivery to address patient priorities and for programs to fill gaps created by the artificial administrative separation of health services, social services, and income assistance.
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Affiliation(s)
- Graham George Macdonald
- Arthritis Research Canada, Richmond, BC, Canada.,Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Cheryl Koehn
- Arthritis Consumer Experts, Vancouver, BC, Canada
| | - Gail Attara
- Canadian Society of Intestinal Research, Vancouver, BC, Canada
| | - Allan Stordy
- Canadian Skin Patient Alliance, Vancouver, BC, Canada
| | - Marilee Allerdings
- Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, BC, Canada
| | - Jenny Leese
- Arthritis Research Canada, Richmond, BC, Canada.,Rehabilitation Sciences Graduate Program, University of British Columbia, Vancouver, BC, Canada
| | - Linda C Li
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Physical Therapy, University of British Columbia, Vancouver, BC, Canada
| | - Catherine L Backman
- Arthritis Research Canada, Richmond, BC, Canada.,Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
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11
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Gibofsky A, Galloway J, Kekow J, Zerbini C, de la Vega M, Lee G, Lee EY, Codreanu C, Koehn C, Steinberg K, Bananis E, de Leon DP, Maniccia A, Dikranian A. Comparison of patient and physician perspectives in the management of rheumatoid arthritis: results from global physician- and patient-based surveys. Health Qual Life Outcomes 2018; 16:211. [PMID: 30413162 PMCID: PMC6230272 DOI: 10.1186/s12955-018-1035-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 10/17/2018] [Indexed: 12/31/2022] Open
Abstract
Background In order to better understand the perspectives of patients and physicians regarding the treatment and management of rheumatoid arthritis (RA), we present and compare results from a patient-based and a physician-based survey developed by the RA NarRAtive advisory panel. Methods The RA NarRAtive initiative is directed by a global advisory panel of 39 healthcare providers and patient organization leaders from 17 countries. A survey of patients self-reporting a diagnosis of RA and a physician-based survey, designed by the advisory panel, were fielded online by Harris Poll from September 2014 to April 2016, and from August 2015 to October 2015, respectively. Results We present findings from 1805 patients whose RA was primarily managed by a rheumatologist, and 1736 physicians managing patients with RA. Results confirmed that RA carries a substantial disease burden; half of the patients surveyed reported stopping participation in certain activities as a result of their disease. While 90% of physicians were satisfied with their communications with their patients regarding RA treatment, 61% of patients felt uncomfortable raising concerns or fears with their physician. Of the patients providing responses, 52% felt that improved dialogue/discussion would optimize their RA management, and 68% of physicians wished that they and their patients talked more about their RA goals and treatment. Overall, 88% of physicians agreed that patients involved in making treatment decisions tend to be more satisfied with their treatment experience. Conclusion The results of these surveys highlight the impact of RA on patients, and a discrepancy between patient and physician views on communication. Further research, focused on improving patient–physician dialogue, shared goal-setting, and treatment planning, is needed. Electronic supplementary material The online version of this article (10.1186/s12955-018-1035-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Allan Gibofsky
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10021, USA.,Hospital for Special Surgery, 535 East 70th Steet, New York, NY, 10021, USA
| | - James Galloway
- King's College London and King's College Hospital, Denmark Hill, London, SE5 9RS, UK
| | - Joern Kekow
- University of Magdeburg, Universitätspl. 2, 39106, Magdeburg, Germany
| | - Cristiano Zerbini
- Centro Paulista de Investigação Clinica, R. Moreira e Costa, 342 - Ipiranga, São Paulo, SP, 04265-000, Brazil
| | - Maria de la Vega
- CEIM Investigaciones Médicas, Laprida 1307, Ciudad De Buenos Aires, 1425, Buenos Aires, Argentina
| | - Gavin Lee
- Hong Kong Sanatorium & Hospital, 2 Village Road, Happy Valley, Hong Kong, SAR, China
| | - Eun Young Lee
- Seoul National University College of Medicine, 103 Daehak-ro (Yeongeon-dong), Jongno-gu, Seoul, 03080, Korea
| | - Catalin Codreanu
- Center for Rheumatic Diseases, University of Medicine and Pharmacy, 37 Dionise Lupu Street, 020021, Bucharest, Romania
| | - Cheryl Koehn
- Arthritis Consumer Experts, 210-1529 West 6th Avenue, Vancouver, BC, V6J 1R1, Canada
| | | | | | | | - Anna Maniccia
- Pfizer Inc, 235 East 42nd Street, New York, NY, 10017, USA.
| | - Ara Dikranian
- Cabrillo Center for Rheumatic Disease, Suite 203, 300 S Pierce St, El Cajon, San Diego, CA, 92020, USA
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12
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Li LC, Shaw CD, Lacaille D, Yacyshyn E, Jones CA, Koehn C, Hoens AM, Geldman J, Sayre EC, Macdonald GG, Leese J, Bansback N. Effects of a Web-Based Patient Decision Aid on Biologic and Small-Molecule Agents for Rheumatoid Arthritis: Results From a Proof-of-Concept Study. Arthritis Care Res (Hoboken) 2018; 70:343-352. [PMID: 28544648 DOI: 10.1002/acr.23287] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 05/16/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. METHODS We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic agent or small-molecule agent or to switch to a new one, and had internet access. Access to ANSWER-2 was provided immediately after enrollment. Outcome measures included 1) the Decisional Conflict Scale (DCS), 2) the Medication Education Impact Questionnaire (MeiQ), and 3) the Partners in Health Scale (PIHS). A paired t-test was used to assess differences pre- and postintervention. RESULTS The majority of the 50 participants were women (n = 40), and the mean ± SD age of participants was 49.6 ± 12.2 years. The median disease duration was 5 years (25th, 75th percentile: 2, 10 years). The mean ± SD DCS score was 45.9 ± 25.1 preintervention and 25.1 ± 21.8 postintervention (mean change of -21.2 of 100 [95% confidence interval (95% CI) -28.1, -14.4], P < 0.001). Before using ANSWER-2, 20% of participants had a DCS score of <25, compared to 52% of participants after the intervention. Similar results were observed in the PIHS (mean ± SD 25.3 ± 14.8 preintervention and 20.4 ± 13.0 postintervention; mean change of -3.7 of 88 [95% CI -6.3, -1.0], P = 0.009). Findings from the MeiQ were mixed, with statistically significant differences found only in the self-management subscales. CONCLUSION Patients' decisional conflict decreased and perceived self-management capacity improved after using ANSWER-2. Future research comparing the effectiveness of ANSWER-2 with that of educational material on biologic agents will provide further insight into its value in RA management.
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Affiliation(s)
- Linda C Li
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
| | | | - Diane Lacaille
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
| | | | | | | | - Alison M Hoens
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
| | | | | | - Graham G Macdonald
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
| | - Jenny Leese
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
| | - Nick Bansback
- University of British Columbia, Vancouver, Canada, and Arthritis Research Canada, Richmond, Canada
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13
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White MI, Dionne CE, Wärje O, Koehoorn M, Wagner SL, Schultz IZ, Koehn C, Williams-Whitt K, Harder HG, Pasca R, Hsu V, McGuire L, Schulz W, Kube D, Wright MD. Physical Activity and Exercise Interventions in the Workplace Impacting Work Outcomes: A Stakeholder-Centered Best Evidence Synthesis of Systematic Reviews. Int J Occup Environ Med 2017; 7:61-74. [PMID: 27112715 PMCID: PMC6816510 DOI: 10.15171/ijoem.2016.739] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Accepted: 03/08/2016] [Indexed: 01/08/2023]
Abstract
Background: The prevention of work disability is beneficial to employees and employers, and mitigates unnecessary societal costs associated with social welfare. Many service providers and employers have initiated workplace interventions designed to reduce unnecessary work disability. Objective: To conduct a best-evidence synthesis of systematic reviews on workplace interventions that address physical activities or exercise and their impact on workplace absence, work productivity or financial outcomes. Methods: Using a participatory research approach, academics and stakeholders identified inclusion and exclusion criteria, built an abstraction table, evaluated systematic review quality and relevance, and interpreted the combined findings. A minimum of two scientists participated in a methodological review of the literature followed by a consensus process. Results: Stakeholders and researchers participated as a collaborative team. 3363 unique records were identified, 115 full text articles and 46 systematic reviews were included, 18 assessed the impact of physical fitness or exercise interventions. 11 focused on general workers rather than workers who were absent from work at baseline; 16 of the reviews assessed work absence, 4 assessed productivity and 6 assessed financial impacts.
Conclusion: The strongest evidence supports the use of short, simple exercise or fitness programs for both workers at work and those absent from work at baseline. For workers at work, simple exercise programs (1–2 modal components) appear to provide similar benefits to those using more complex multimodal interventions. For workers off-work with subacute low back pain, there is evidence that some complex exercise programs may be more effective than simple exercise interventions, especially if they involve workplace stakeholder engagement, communication and coordination with employers and other stakeholders. The development and utilization of standardized definitions, methods and measures and blinded evaluation would improve research quality and strengthen stakeholder-centered guidance.
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Affiliation(s)
- M I White
- Canadian Institute for the Relief of Pain and Disability, Vancouver, Canada, and Department of Family Practice, University of British Columbia, Vancouver, Canada.
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14
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Wagner SL, Koehn C, White MI, Harder HG, Schultz IZ, Williams-Whitt K, Warje O, Dionne CE, Koehoorn M, Pasca R, Hsu V, McGuire L, Schulz W, Kube D, Wright MD. Mental Health Interventions in the Workplace and Work Outcomes: A Best-Evidence Synthesis of Systematic Reviews. Int J Occup Environ Med 2016; 7:1-14. [PMID: 26772593 PMCID: PMC6816521 DOI: 10.15171/ijoem.2016.607] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 10/28/2015] [Indexed: 01/08/2023]
Abstract
Background: Mental health issues in the workplace are a growing concern among organizations and policymakers, but it remains unclear what interventions are effective in preventing mental health problems and their associated organizational consequences. This synthesis reports on workplace mental health interventions that impact absenteeism, productivity and financial outcomes. Objective: To determine the level of evidence supporting mental health interventions as valuable to work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO and TRIP. Grey literature searches included health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. The assessment of articles for inclusion criteria and methodological quality was conducted independently by two or more researchers, with differences resolved through consensus. Results: The search resulted in 3363 titles, of which 3248 were excluded following title/abstract review, with 115 articles retrieved for full-text review. 14 articles finally met the inclusion criteria and are summarized in this synthesis. Conclusion: There is moderate evidence for the effectiveness of workplace mental health interventions on improved workplace outcomes. Certain types of programs, such as those incorporating both mental and physical health interventions, multicomponent mental health and/or psychosocial interventions, and exposure in vivo containing interventions for particular anxiety disorders had a greater level of research evidence to support their effectiveness.
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Affiliation(s)
- S L Wagner
- School of Health Sciences; University of Northern British Columbia, Prince George, BC, Canada.
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15
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Koehn C, Dikranian A, Maniccia A, Bananis E. OP0248-PARE Understanding The Importance of A Patient's Role in The Management of Ra: Results from A Patient-Based Survey Developed by The Ra Narrative Global Advisory Panel. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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16
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Wagner SL, White MI, Schultz IZ, Williams-Whitt K, Koehn C, Dionne CE, Koehoorn M, Harder HG, Pasca R, Wärje O, Hsu V, McGuire L, Lama I, Schulz W, Kube D, Wright MD. Social Support and Supervisory Quality Interventions in the Workplace: A Stakeholder-Centered Best-Evidence Synthesis of Systematic Reviews on Work Outcomes. Int J Occup Environ Med 2016; 6:189-204. [PMID: 26498048 PMCID: PMC6977048 DOI: 10.15171/ijoem.2015.608] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Accepted: 09/21/2015] [Indexed: 11/17/2022]
Abstract
Background: There is controversy surrounding the impact of workplace interventions aimed at improving social support and supervisory quality on absenteeism, productivity and financial outcomes. Objective: To determine the value of social support interventions for work outcomes. Methods: Databases were searched for systematic reviews between 2000 and 2012 to complete a synthesis of systematic reviews guided by the PRISMA statement and the IOM guidelines for systematic reviews. Assessment of articles for inclusion and methodological quality was conducted independently by at least two researchers, with differences resolved by consensus. Results: The search resulted in 3363 titles of which 3248 were excluded following title/ abstract review, leaving 115 articles that were retrieved and underwent full article review. 10 articles met the set inclusion criteria, with 7 focusing on social support, 2 on supervisory quality and 1 on both. We found moderate and limited evidence, respectively, that social support and supervisory quality interventions positively impact workplace outcomes. Conclusion: There is moderate evidence that social support and limited evidence that supervisory quality interventions have a positive effect on work outcomes.
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Affiliation(s)
- S L Wagner
- School of Health Sciences, University of Northern British Columbia, Prince George, Canada.
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17
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Schellart P, Trinh TNG, Buitink S, Corstanje A, Enriquez JE, Falcke H, Hörandel JR, Nelles A, Rachen JP, Rossetto L, Scholten O, Ter Veen S, Thoudam S, Ebert U, Koehn C, Rutjes C, Alexov A, Anderson JM, Avruch IM, Bentum MJ, Bernardi G, Best P, Bonafede A, Breitling F, Broderick JW, Brüggen M, Butcher HR, Ciardi B, de Geus E, de Vos M, Duscha S, Eislöffel J, Fallows RA, Frieswijk W, Garrett MA, Grießmeier J, Gunst AW, Heald G, Hessels JWT, Hoeft M, Holties HA, Juette E, Kondratiev VI, Kuniyoshi M, Kuper G, Mann G, McFadden R, McKay-Bukowski D, McKean JP, Mevius M, Moldon J, Norden MJ, Orru E, Paas H, Pandey-Pommier M, Pizzo R, Polatidis AG, Reich W, Röttgering H, Scaife AMM, Schwarz DJ, Serylak M, Smirnov O, Steinmetz M, Swinbank J, Tagger M, Tasse C, Toribio MC, van Weeren RJ, Vermeulen R, Vocks C, Wise MW, Wucknitz O, Zarka P. Probing Atmospheric Electric Fields in Thunderstorms through Radio Emission from Cosmic-Ray-Induced Air Showers. Phys Rev Lett 2015; 114:165001. [PMID: 25955053 DOI: 10.1103/physrevlett.114.165001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Indexed: 06/04/2023]
Abstract
We present measurements of radio emission from cosmic ray air showers that took place during thunderstorms. The intensity and polarization patterns of these air showers are radically different from those measured during fair-weather conditions. With the use of a simple two-layer model for the atmospheric electric field, these patterns can be well reproduced by state-of-the-art simulation codes. This in turn provides a novel way to study atmospheric electric fields.
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Affiliation(s)
- P Schellart
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - T N G Trinh
- University of Groningen, KVI Center for Advanced Radiation Technology, 9700 AB Groningen, The Netherlands
| | - S Buitink
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
- Astrophysical Institute, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium
| | - A Corstanje
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - J E Enriquez
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - H Falcke
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
- Nikhef, Science Park Amsterdam, 1098 XG Amsterdam, The Netherlands
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - J R Hörandel
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
- Nikhef, Science Park Amsterdam, 1098 XG Amsterdam, The Netherlands
| | - A Nelles
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - J P Rachen
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - L Rossetto
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - O Scholten
- University of Groningen, KVI Center for Advanced Radiation Technology, 9700 AB Groningen, The Netherlands
- Vrije Universiteit Brussel, Dienst ELEM, B-1050 Brussels, Belgium
| | - S Ter Veen
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - S Thoudam
- Department of Astrophysics/IMAPP, Radboud University Nijmegen, PO Box 9010, 6500 GL Nijmegen, The Netherlands
| | - U Ebert
- Center for Mathematics and Computer Science (CWI), PO Box 94079, 1090 GB Amsterdam, The Netherlands
- Eindhoven University of Technology (TU/e), PO Box 513, 5600 MB Eindhoven, The Netherlands
| | - C Koehn
- Center for Mathematics and Computer Science (CWI), PO Box 94079, 1090 GB Amsterdam, The Netherlands
| | - C Rutjes
- Center for Mathematics and Computer Science (CWI), PO Box 94079, 1090 GB Amsterdam, The Netherlands
| | - A Alexov
- Space Telescope Science Institute, 3700 San Martin Drive, Baltimore, Maryland 21218, USA
| | - J M Anderson
- Helmholtz-Zentrum Potsdam, DeutschesGeoForschungsZentrum GFZ, Department 1: Geodesy and Remote Sensing, Telegrafenberg, A17, 14473 Potsdam, Germany
| | - I M Avruch
- SRON Netherlands Institute for Space Research, PO Box 800, 9700 AV Groningen, The Netherlands
- Kapteyn Astronomical Institute, PO Box 800, 9700 AV Groningen, The Netherlands
| | - M J Bentum
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- University of Twente, PO Box 217, 7500 AE Enschede, The Netherlands
| | - G Bernardi
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - P Best
- Institute for Astronomy, University of Edinburgh, Royal Observatory of Edinburgh, Blackford Hill, Edinburgh EH9 3HJ, United Kingdom
| | - A Bonafede
- University of Hamburg, Gojenbergsweg 112, 21029 Hamburg, Germany
| | - F Breitling
- Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, 14482 Potsdam, Germany
| | - J W Broderick
- Astrophysics, University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
- School of Physics and Astronomy, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - M Brüggen
- University of Hamburg, Gojenbergsweg 112, 21029 Hamburg, Germany
| | - H R Butcher
- Research School of Astronomy and Astrophysics, Australian National University, Mt. Stromlo Observatory, via Cotter Road, Weston, Australian Capital Territory 2611, Australia
| | - B Ciardi
- Max Planck Institute for Astrophysics, Karl Schwarzschild Straße 1, 85741 Garching, Germany
| | - E de Geus
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- SmarterVision BV, Oostersingel 5, 9401 JX Assen, The Netherlands
| | - M de Vos
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - S Duscha
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - J Eislöffel
- Thüringer Landessternwarte, Sternwarte 5, D-07778 Tautenburg, Germany
| | - R A Fallows
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - W Frieswijk
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - M A Garrett
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Leiden Observatory, Leiden University, PO Box 9513, 2300 RA Leiden, The Netherlands
| | - J Grießmeier
- LPC2E, Universíte d'Orleans/CNRS, 45071 Orleans Cedex 2, France
- Station de Radioastronomie de Nancay, Observatoire de Paris, CNRS/INSU, USR 704, Universíte Orleans, OSUC, Route de Souesmes, 18330 Nancay, France
| | - A W Gunst
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - G Heald
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Kapteyn Astronomical Institute, PO Box 800, 9700 AV Groningen, The Netherlands
| | - J W T Hessels
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Anton Pannekoek Institute, University of Amsterdam, Postbus 94249, 1090 GE Amsterdam, The Netherlands
| | - M Hoeft
- Thüringer Landessternwarte, Sternwarte 5, D-07778 Tautenburg, Germany
| | - H A Holties
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - E Juette
- Astronomisches Institut der Ruhr-Universität Bochum, Universitaetsstrasse 150, 44780 Bochum, Germany
| | - V I Kondratiev
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Astro Space Center of the Lebedev Physical Institute, Profsoyuznaya Street 84/32, Moscow 117997, Russia
| | - M Kuniyoshi
- National Astronomical Observatory of Japan, Tokyo 181-8588, Japan
| | - G Kuper
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - G Mann
- Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, 14482 Potsdam, Germany
| | - R McFadden
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - D McKay-Bukowski
- Sodankylä Geophysical Observatory, University of Oulu, Tähteläntie 62, 99600 Sodankylä, Finland
- STFC Rutherford Appleton Laboratory, Harwell Science and Innovation Campus, Didcot OX11 0QX, United Kingdom
| | - J P McKean
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Kapteyn Astronomical Institute, PO Box 800, 9700 AV Groningen, The Netherlands
| | - M Mevius
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Kapteyn Astronomical Institute, PO Box 800, 9700 AV Groningen, The Netherlands
| | - J Moldon
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - M J Norden
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - E Orru
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - H Paas
- Center for Information Technology (CIT), University of Groningen, PO Box 72, 9700 AB Groningen, The Netherlands
| | - M Pandey-Pommier
- Centre de Recherche Astrophysique de Lyon, Observatoire de Lyon, 9 Avenue Charles André, 69561 Saint Genis Laval Cedex, France
| | - R Pizzo
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - A G Polatidis
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - W Reich
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - H Röttgering
- Leiden Observatory, Leiden University, PO Box 9513, 2300 RA Leiden, The Netherlands
| | - A M M Scaife
- School of Physics and Astronomy, University of Southampton, Southampton SO17 1BJ, United Kingdom
| | - D J Schwarz
- Fakultät für Physik, Universität Bielefeld, Postfach 100131, D-33501 Bielefeld, Germany
| | - M Serylak
- Astrophysics, University of Oxford, Denys Wilkinson Building, Keble Road, Oxford OX1 3RH, United Kingdom
| | - O Smirnov
- Department of Physics and Electronics, Rhodes University, PO Box 94, Grahamstown 6140, South Africa
- SKA South Africa, 3rd Floor, The Park, Park Road, Pinelands 7405, South Africa
| | - M Steinmetz
- Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, 14482 Potsdam, Germany
| | - J Swinbank
- Anton Pannekoek Institute, University of Amsterdam, Postbus 94249, 1090 GE Amsterdam, The Netherlands
| | - M Tagger
- LPC2E, Universíte d'Orleans/CNRS, 45071 Orleans Cedex 2, France
| | - C Tasse
- LESIA, UMR CNRS 8109, Observatoire de Paris, 92195 Meudon, France
| | - M C Toribio
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - R J van Weeren
- Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, Massachusetts 02138, USA
| | - R Vermeulen
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
| | - C Vocks
- Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, 14482 Potsdam, Germany
| | - M W Wise
- ASTRON, Netherlands Institute for Radio Astronomy, Postbus 2, 7990 AA Dwingeloo, The Netherlands
- Anton Pannekoek Institute, University of Amsterdam, Postbus 94249, 1090 GE Amsterdam, The Netherlands
| | - O Wucknitz
- Max-Planck-Institut für Radioastronomie, Auf dem Hügel 69, 53121 Bonn, Germany
| | - P Zarka
- LESIA, UMR CNRS 8109, Observatoire de Paris, 92195 Meudon, France
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Williams-Whitt K, White MI, Wagner SL, Schultz IZ, Koehn C, Dionne CE, Koehoorn M, Harder H, Pasca R, Warje O, Hsu V, McGuire L, Schulz W, Kube D, Hook A, Wright MD. Job demand and control interventions: a stakeholder-centered best-evidence synthesis of systematic reviews on workplace disability. Int J Occup Environ Med 2015; 6:61-78. [PMID: 25890601 PMCID: PMC6977041 DOI: 10.15171/ijoem.2015.553] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/15/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Physical and psychological job demands in combination with the degree of control a worker has over task completion, play an important role in reducing stress. Occupational stress is an important, modifiable factor affecting work disability. However, the effectiveness of reducing job demands or increasing job control remains unclear, particularly for outcomes of interest to employers, such as absenteeism or productivity. OBJECTIVE This systematic review reports on job demand and control interventions that impact absenteeism, productivity and financial outcomes. METHODS A stakeholder-centered best-evidence synthesis was conducted with researcher and stakeholder collaboration throughout. Databases and grey literature were searched for systematic reviews between 2000 and 2012: Medline, EMBASE, the Cochrane Database of Systematic Reviews, DARE, CINAHL, PsycINFO, TRIP, health-evidence.ca, Rehab+, National Rehabilitation Information Center (NARIC), and Institute for Work and Health. Articles were assessed independently by two researchers for inclusion criteria and methodological quality. Differences were resolved through consensus. RESULTS The search resulted in 3363 unique titles. After review of abstracts, 115 articles were retained for full-text review. 11 articles finally met the inclusion criteria and are summarized in this synthesis. The best level of evidence we found indicates that multimodal job demand reductions for either at-work or off-work workers will reduce disability-related absenteeism. CONCLUSION In general, the impacts of interventions that aim to reduce job demands or increase job control can be positive for the organization in terms of reducing absenteeism, increasing productivity and cost-effectiveness. However, more high quality research is needed to further assess the relationships and quantify effect sizes for the interventions and outcomes reviewed in this study.
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Affiliation(s)
- K Williams-Whitt
- Faculty of Management, University of Lethbridge, Calgary, AB, Canada.
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Thiel J, Emmerich F, Neagu M, Salzer U, Voll RE, Koehn C, Venhoff N. THU0017 The Role of HLA DQ2 and DQ8 in Dissecting Celiac-Like Disease in Common Variable Immunodeficiency. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
PURPOSE OF REVIEW People with arthritis play major roles in treatment and research. This review summarises the current knowledge on tools for enhancing shared-decision making in arthritis care; individual and family involvement in rehabilitation; and the consumer's role in arthritis research. RECENT FINDINGS There are discrepancies in the use of appropriate arthritis treatment. To facilitate evidence-informed treatment choices, a number of decision aids have been developed. A recent systematic review concluded that decision aids could improve the shared-decision making process in a variety of diseases; but only one clinical trial was found on a musculoskeletal condition (back surgery). The evidence on family member participation in arthritis education programs is mixed, partly due to a lack of content specifically targeting family members in some studies. Finally, people with arthritis are playing important roles as collaborators in research. Early experience indicates a mutually beneficial relationship for both the individual and researchers. SUMMARY This review offers three recommendations: First, further clinical trials are needed to test the effectiveness of decision aids in arthritis management. Second, education programs involving strong social support training for family members may improve client outcomes. Third, we encourage further studies to examine the experiences and challenges of people living with arthritis when participating as research partners.
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Affiliation(s)
- Linda C Li
- University of British Columbia, Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada.
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