- Rheumatoid arthritis (RA) affects up to 1% of the U.S. population, causing increased disability and mortality and costs of more than $20 billion annually.
- Over the past 20 years, more than 10 new medications for RA have been approved by the FDA. These advances have improved outcomes, but also increased the complexity of treatment decisions for patients and clinicians.
- The RA Choice decision aid addresses key issues for 12 RA medications through a set of 5 cards: cost, how often medicines are taken, how soon they work, side effects, and special considerations such as pregnancy or exposure to tuberculosis.
- RA Choice presents information in plain language and pictographs and was designed to facilitate conversation between patients and clinicians to support shared decision making (SDM).
- In a pilot study of a diverse RA population, patients who reviewed a low literacy medication summary guide and used RA Choice with their doctor reported significantly lower decisional conflict and 100% had adequate RA knowledge compared to patients who did not use the tools.
RA Medication Summary guide (“Your Guide to Rheumatoid Arthritis Medicines):
RA Choice decision aid:
Patients receive the medication guide in their preferred language prior to the clinic visit (in waiting room). If a patient has poorly controlled arthritis, the clinician can initiate a discussion of a medication change by introducing the decision aid and asking the patient which issue he/she would like to discuss first. The decision aid should be used as a tool to facilitate discussion between the patient and provider, with the provider addressing patient questions and concerns as they arise. RA Choice is intended to enhance the SDM process, with the provider offering detailed information on specific treatment options to the patient.
RA Choice in Practice:
- Shared Decision Making Resource Center
- Decision Aids in Literature (please see subsection on Rheumatoid Arthritis – coming soon)
- “Live Better With Rheumatoid Arthritis” – additional guide developed for patients with RA available in English or Spanish: http://www.acponline.org/patients_families/products/brochures/
- Publications about RA Choice:
- Use of Low-Literacy Decision Aid to Enhance Knowledge and Reduce Decisional Conflict Among a Diverse Population of Adults With Rheumatoid Arthritis: Results of a Pilot Study. Barton JL, Trupin L, Schillinger D, Evans-Young G, Imboden J, Montori VM, Yelin E. Arthritis Care Res (Hoboken). 2016 Jul;68(7):889-98. doi: 10.1002/acr.22801.
- The design of a low literacy decision aid about rheumatoid arthritis medications developed in three languages for use during the clinical encounter. Barton JL, Koenig CJ, Evans-Young G, Trupin L, Anderson J, Ragouzeos D, Breslin M, Morse T, Schillinger D, Montori VM, Yelin EH. BMC Med Inform Decis Mak. 2014 Nov 25;14:104. doi: 10.1186/s12911-014-0104-8.
- Dr. Jennifer Barton's blog post