The development of a tailored symptom assessment tool to enhance patient-centere

该建议解决了少数民族、英语水平低、社会经济地位低的类风湿性关节炎患者在治疗和结果方面的差异。该提案还指出，主要语言不是英语的RA患者和出生在美国以外的RA患者在他们对疾病活动性的评估与医生的评估之间存在更大的不一致。拟议项目的总体目标是改善RA患者与其提供者之间关于疾病活动和治疗选择的沟通。据推测，改善沟通可能提供一种方法，可以改善获得已证实有效的类风湿性关节炎治疗的机会，从而减少结果的差异。拟议的D&F的具体目的是：1)评估不同患者队列中RA疾病活动和治疗选择的患者和提供者之间信息交换的质量；2)开发一种计算机化工具，以改善关于患者报告的症状和治疗偏好的沟通；并且，3)通过进行小型随机试验，对该工具在临床环境中的可行性以及患者和提供者在遇到问题时处理的症状之间的一致性进行初步评估。

The proposal addresses the observed disparities in treatments and outcomes experienced by persons with RA who are members of racial and ethnic minorities, have low levels of English language proficiency, and are of lower socioeconomic status. The proposal also addresses the observation that persons with RA with a primary language other than English and those born outside the U.S. experience a greater discordance between their assessments of disease activity and those of their providers. The overarching aim of the proposed project is to improve communication between patients with RA and their providers about disease activity and treatment choices. It is hypothesized that improved communication may provide a method of improving access to treatments of proven effectiveness for RA and in so doing reduce differences in outcomes. The specific aims of the proposed D&F are to: 1) assess the quality of information exchange between patients and providers regarding disease activity and treatment choices in RA in a cohort of diverse patients; 2) develop a computerized tool to improve communication about patient-reported symptoms and treatment preferences; and, 3) provide a preliminary assessment of the utility of the tool in terms of its feasibility in a clinical environment and the congruence between patients and providers in the symptoms addressed in an encounter by conducting a small pilot randomized trial. The specific aims will be achieved by analysis of data from the RA Outcomes Study (RA-OS). The RA-OS includes a uniquely diverse set of 450 respondents. The first annual survey of the RA-OS will include items to obtain the data for Aim 1. The information from the analysis of the survey data will be combined with information from focus groups among members of the RA-OS and physicians and that from conscientious literature reviews to develop the computerized tool in Aim 2. In Aim 3, 50 members of the RA-OS will participate in the pilot trial of the tool administered in a clinic visit. The overall goal of the project is to improve the quality of communication between patients with RA and providers and, therefore, reduce disparities in RA outcomes by improving patients' understanding of the disease and its treatments.