Helping Adults with RA PREVAIL: Developing a model to Preserve Valued Activities In Life

帮助患有 RA 的成年人患病：开发一个模型来保留生活中有价值的活动

• 批准号: 10436905
• 负责人: Louise M. Thoma
• 金额: $ 13.25万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10436905
• 关键词: Address; Adult; Antirheumatic Agents; Autoimmune Diseases; Award; Canada; Caring; Clinical; Clinical Trials; Collection; Country; Development; Development Plans; Disease; Early identification; Exercise; Feedback; Germany; Goals; Health Services Research; Impairment; Interview; K-Series Research Career Programs; Knowledge; Learning; Life; Measurement; Medication Management; Mentors; Methodology; Modeling; Musculoskeletal Diseases; Outcome; Pain; Patient Recruitments; Patients; Pharmacology; Phase; Physical therapy; Physical therapy exercises; Pilot Projects; Preparation; Process; Provider; Questionnaires; Recommendation; Regimen; Rehabilitation therapy; Research; Research Proposals; Rheumatism; Rheumatoid Arthritis; Sampling; Screening Result; Screening procedure; Specificity; Structure; Surveys; Therapeutic exercise; Training; United States; Value of Life; acceptability and feasibility; base; career development; clinical research site; cohort; design; disability; disability risk; effectiveness testing; exercise intervention; exercise rehabilitation; feasibility testing; follow-up; functional decline; improved; joint destruction; joint inflammation; participant retention; physical therapist; pilot test; pilot trial; preservation; prospective; randomized trial; rheumatologist; routine care; screening; therapy development; tool; treatment guidelines

PROJECT ABSTRACT. Disability continues to be common in adults with RA despite pharmacological advances two decades ago that reduced disease activity. Physical therapy and exercise are effective in reducing disability in adults with RA, however they are underutilized in rheumatologic care, particularly in the United States. Key contributors to this underutilization includes lack of sufficient specificity for physical therapy and exercise recommendations in treatment guidelines leaving rheumatologists unclear when to refer and lack of systematic processes for integrating rehabilitation in routine RA care. To facilitate appropriate referral to physical therapy and exercise for adults with RA, we created a model to PREserve Valued Activities In Life (PREVAIL) based on the premise that early identification of functional decline will help direct physical therapy and exercise referrals to address impairments before irreversible disability ensues. PREVAIL inserts disability screening into routine RA care and uses the results of the screening to direct a physical therapy referral matched to disability level and RA- specific exercise guidance. The objective of this research proposal is to develop and pilot test a scalable model (PREVAIL) for integrating rehabilitation into routine care to preserve function and delay disability in adults with RA. The aims will (1) define the distribution of disability levels and related functional needs in adults with RA, (2) obtain key information from patients and providers on the acceptability and feasibility of the PREVAIL model, and (3) conduct a pilot trial to determine feasibility and acceptability of the refined PREVAIL model in at least 50 adults with RA. Successful completion of this proposal will establish feasibility and acceptability, and set the stage for to integrate PREVAIL into rheumatologic care on a larger scale. My long-term goal is to mitigate disability in adults with rheumatic and musculoskeletal diseases. The objectives of this career development award are to (1) deepen my current knowledge of rheumatic disease, specifically in rheumatoid arthritis (RA) care to better understand how to integrate rehabilitation, (2) train in health services research, particularly intervention development and clinical trials, and (3) prepare to design and execute a larger clinical trial in my next phase. My mentors are experts in health services research, rheumatologic care, and RA disability measurement. Together, we developed this research proposal and career development plan to accelerate my scientific development towards my long-term goal and research independence.

项目摘要。 尽管二十年前药理学取得了进展，但成人类风湿性关节炎患者的残疾仍然很常见 疾病活动减少。物理治疗和锻炼可有效减少成人类风湿性关节炎患者的残疾， 然而，它们在风湿病治疗中并未得到充分利用，特别是在美国。对此的主要贡献者 未充分利用包括物理治疗和运动建议缺乏足够的特异性 治疗指南使风湿病学家不清楚何时转诊，并且缺乏系统的流程 将康复纳入常规 RA 护理中。促进适当的物理治疗和锻炼 对于患有 RA 的成年人，我们基于以下前提创建了一个模型来保留生活中有价值的活动 (PREVAIL) 及早识别功能衰退将有助于指导物理治疗和运动转诊以解决 发生不可逆转的残疾之前的损伤。 PREVAIL 将残疾筛查纳入常规 RA 护理中 并使用筛查结果来指导与残疾水平和 RA- 相匹配的物理治疗转诊 具体的运动指导。该研究计划的目标是开发和试点测试可扩展的模型 （PREVAIL）将康复纳入日常护理中，以保留成人的功能并延缓残疾 RA。目标将 (1) 确定患有 RA 的成人的残疾水平和相关功能需求的分布， (2) 从患者和提供者处获取有关 PREVAIL 的可接受性和可行性的关键信息 (3) 进行试点试验以确定改进后的 PREVAIL 模型的可行性和可接受性 至少 50 名成人患有 RA。该提案的成功完成将确立可行性和可接受性，并且 为更大规模地将 PREVAIL 纳入风湿病护理奠定了基础。我的长期目标是 减轻患有风湿病和肌肉骨骼疾病的成人的残疾。这个职业的目标 发展奖旨在 (1) 加深我目前对风湿病的了解，特别是类风湿病 关节炎 (RA) 护理，以更好地了解如何整合康复，(2) 卫生服务研究培训， 特别是干预开发和临床试验，以及（3）准备设计和执行更大规模的临床试验 在我的下一阶段进行审判。我的导师是健康服务研究、风湿病护理和 RA 领域的专家 残疾测量。我们共同制定了这项研究计划和职业发展计划 加速我的科学发展，实现我的长期目标和研究独立性。