EducAR: implementing a multicomponent strategy to improve therapeutic adherence in rheumatoid arthritis.

IF 5.1 2区医学 Q1 RHEUMATOLOGY

RMD Open Pub Date : 2025-02-27 DOI:10.1136/rmdopen-2024-004989

María Ahijón Lana, Francisca Sivera Mascaró, Antonio Fernández-Nebro, Sara Muntadas Castelló, Marina Pérez, Teresa Otón, María Jesús García de Yébenes, Loreto Carmona

{"title":"EducAR: implementing a multicomponent strategy to improve therapeutic adherence in rheumatoid arthritis.","authors":"María Ahijón Lana, Francisca Sivera Mascaró, Antonio Fernández-Nebro, Sara Muntadas Castelló, Marina Pérez, Teresa Otón, María Jesús García de Yébenes, Loreto Carmona","doi":"10.1136/rmdopen-2024-004989","DOIUrl":null,"url":null,"abstract":"Introduction: The EULAR points to consider (PtC) for reducing non-adherence need implementation.Objectives: To design, implement and evaluate a strategy based on the PtC to improve treatment adherence in rheumatoid arthritis (RA).Methods: A multidisciplinary panel cocreated an intervention that was subsequently tested in a cluster trial, where centres were randomised to access the developed intervention or follow the standard of care (SOC). 6-month initiation and implementation adherence were measured in consecutive patients with <2 years of RA. The results were discussed among the centres assigned to the intervention to explore barriers and facilitators to implementation.Results: The intervention was a two-sided website. The items on the patient site mainly addressed disease and treatment education, self-management and peer support. The healthcare professional site has tutorials on communication to improve trust and adherence, plus shared decision-making aids. It was tested in 141 RA patients (67 control and 74 intervention). Both groups increased adherence at 6 months, mainly in the control group (48% to 67% vs 42% to 47% in the intervention group). Implementation had been very low in relation to barriers identified as lack of time, inadequate focus (exclusively for nurses) and consideration of the current SOC as adequate.Conclusion: Despite designing an intervention based on the best evidence, the results were inconclusive; the lack of a detected effect could be explained by the limited implementation, which was insufficient for the complexity of the changes required (change of culture).Trial register number: ClinicalTrials.gov ID NCT05425485.","PeriodicalId":21396,"journal":{"name":"RMD Open","volume":"11 1","pages":""},"PeriodicalIF":5.1000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873333/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"RMD Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/rmdopen-2024-004989","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: The EULAR points to consider (PtC) for reducing non-adherence need implementation.

Objectives: To design, implement and evaluate a strategy based on the PtC to improve treatment adherence in rheumatoid arthritis (RA).

Methods: A multidisciplinary panel cocreated an intervention that was subsequently tested in a cluster trial, where centres were randomised to access the developed intervention or follow the standard of care (SOC). 6-month initiation and implementation adherence were measured in consecutive patients with <2 years of RA. The results were discussed among the centres assigned to the intervention to explore barriers and facilitators to implementation.

Results: The intervention was a two-sided website. The items on the patient site mainly addressed disease and treatment education, self-management and peer support. The healthcare professional site has tutorials on communication to improve trust and adherence, plus shared decision-making aids. It was tested in 141 RA patients (67 control and 74 intervention). Both groups increased adherence at 6 months, mainly in the control group (48% to 67% vs 42% to 47% in the intervention group). Implementation had been very low in relation to barriers identified as lack of time, inadequate focus (exclusively for nurses) and consideration of the current SOC as adequate.

Conclusion: Despite designing an intervention based on the best evidence, the results were inconclusive; the lack of a detected effect could be explained by the limited implementation, which was insufficient for the complexity of the changes required (change of culture).

Trial register number: ClinicalTrials.gov ID NCT05425485.

查看原文本刊更多论文

EducAR：实施多要素战略，提高类风湿关节炎患者的治疗依从性。

简介：需要实施 EULAR 减少非依从性的考虑要点（PtC）：设计、实施并评估一项基于PtC的战略，以改善类风湿关节炎（RA）患者的治疗依从性：多学科小组共同制定了一项干预措施，随后在分组试验中对其进行了测试，各中心被随机分配接受制定的干预措施或遵循标准护理（SOC）。结果：干预措施是一个双面网站：干预措施是一个双面网站。患者网站上的项目主要涉及疾病和治疗教育、自我管理和同伴支持。医护人员网站上有关于沟通的教程，以提高信任度和依从性，还有共同决策辅助工具。该网站在 141 名 RA 患者（67 名对照组和 74 名干预组）中进行了测试。6个月后，两组患者的依从性都有所提高，主要是对照组（48%至67%，干预组为42%至47%）。由于缺乏时间、重点不突出（仅针对护士）以及认为目前的 SOC 足够等障碍，实施率非常低：尽管根据最佳证据设计了一项干预措施，但结果并不确定；没有发现效果的原因可能是实施力度有限，不足以应对所需的复杂变化（文化变革）：试验登记号：ClinicalTrials.gov ID NCT05425485。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

RMD Open RHEUMATOLOGY-

CiteScore

7.30

自引率

6.50%

发文量

205

审稿时长

14 weeks

期刊介绍： RMD Open publishes high quality peer-reviewed original research covering the full spectrum of musculoskeletal disorders, rheumatism and connective tissue diseases, including osteoporosis, spine and rehabilitation. Clinical and epidemiological research, basic and translational medicine, interesting clinical cases, and smaller studies that add to the literature are all considered.