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

该提案解决了观察到的RA患者在治疗和结果方面的差异，这些人是种族和少数族裔成员，英语水平较低，社会经济地位较低。该提案还解决了这样的观察，即主要语言不是英语的RA患者和在美国以外出生的人对疾病活动的评估与其提供者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类风湿关节炎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，改善沟通可以提供一种方法，改善获得已证实有效的类风湿性关节炎治疗的机会，并通过这样做减少结果的差异。拟议的D&F的具体目标是：1)在不同的患者队列中，评估患者和提供者之间关于RA疾病活动和治疗选择的信息交换的质量；2)开发一个计算机化工具，以改善关于患者报告的症状和治疗偏好的沟通；以及，3)通过进行一项小型试验性随机试验，初步评估该工具在临床环境中的可行性，以及患者和提供者之间在遇到的症状方面的一致性。 具体目标将通过分析RA成果研究(RA-OS)的数据来实现。RA-OS包括一组独特的多样化的450名受访者。对RA-OS的第一次年度调查将包括为AIM 1获取数据的项目。分析调查数据的信息将与RA-OS成员和医生中的焦点小组的信息以及认真的文献审查中的信息结合在一起，以开发AIM 2的计算机化工具。在AIM 3中，RA-OS的50名成员将参加在临床访问中实施的工具的试点试验。 该项目的总体目标是改善类风湿性关节炎患者和提供者之间的沟通质量，从而通过提高患者对疾病及其治疗的了解来减少类风湿性关节炎结果的差异。

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.