Optimization of hyperlipidemia management among patients with rheumatoid arthritis: A patient-centered intervention development

类风湿关节炎患者高脂血症管理的优化：以患者为中心的干预措施发展

• 批准号: 10079121
• 负责人: Iris Y Navarro-Millán
• 金额: $ 0.06万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2022-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10079121
• 关键词: Achievement; Active Learning; Address; Affect; Alabama; Arthritis; Attention; Attitude; Award; Belief; Cardiovascular Diseases; Caregivers; Caring; Cause of Death; Cholesterol; Chronic; Chronic Disease; Clinical Trials; Collaborations; Communities; Data; Databases; Decision Making; Development; Diabetes Mellitus; Disease; Disease remission; Education; Focus Groups; Foundational Skills; Foundations; Funding; Future; Geographic state; Goals; Health Insurance; Health behavior; Human; Hyperlipidemia; Hypertension; Individual; Institution; Intervention; Intervention Studies; Intervention Trial; Lipids; Low-Density Lipoproteins; Medical; Mentors; Methods; Nature; Patient Education; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Persons; Pharmaceutical Preparations; Pharmacists; Physicians; Population; Primary Care Physician; Program Evaluation; Qualitative Methods; Qualitative Research; Randomized; Research; Research Activity; Research Institute; Research Methodology; Research Personnel; Research Training; Rheumatism; Rheumatoid Arthritis; Rheumatology; Risk; Risk Factors; Risk Management; Risk Reduction; SECTM1 gene; Self Administration; Self Efficacy; Self-Direction; Telephone; Testing; Training; Training Activity; Universities; Work; base; cardiovascular disorder risk; cardiovascular risk factor; career; design; evidence base; high risk; improved; insurance claims; member; novel; patient oriented; peer coaching; peer support; pragmatic trial; primary outcome; programs; recruit; relative effectiveness; rheumatologist; screening; secondary outcome; shared decision making; skills; social cognitive theory; success; theories; therapy design; therapy development; tool; treatment adherence

Project Summary One of the greatest success stories in rheumatology - the achievement of rheumatoid arthritis (RA) remission - is tempered by the fact that individuals with RA are dramatically under evaluated and under treated to reduce cardiovascular disease (CVD) risk. This project will build the foundation for an intervention that will test the hypothesis that the patient-centered intervention tailored to the RA population that I will develop as part of this K23 will improve hyperlipidemia screening and treatment in RA, thereby reducing CVD risk. For the K23 and future projects, we will build on the University of Alabama at Birmingham (UAB)'s collaboration with the Patient-Centered Outcomes Research Institute (PCORI)-funded ArthritisPower Patient Powered Research Network (PPRN). We will work in partnership with members of ArthritisPower >2,000 RA patients and caregivers in all 50 US states. In this proposal, we will develop and test the feasibility of a novel theory-driven (Using Bandura's Social Cognitive Theory), patient-centered educational decision support/peer coaching intervention, thereby mastering foundational skills in the development and implementation of patient- engaged intervention research. The aims of this proposal are: Aim 1: To identify patient and physician barriers to CVD risk reduction in RA. During this aim, we will apply qualitative methods to elicit attitudes, beliefs and barriers regarding CVD and CVD risk reduction. Aim 2: To develop an intervention designed to optimize lipid screening and management in RA patients. We will build the intervention based on the data collected in Aim 1. This will consist of patient education and a decision support program to facilitate screening for hyperlipidemia or initiation of lipid lowering therapy (LLT) (primary outcome) and self-efficacy in taking lipid lowering therapy and patient activation (secondary outcome). Aim 3: To pilot test the intervention developed in Aim 2. During this aim, we will apply methods related to clinical trials to test the feasibility of the newly developed intervention. This study will result in a patient-centered intervention to facilitate the first steps needed to address the gap in screening and management of hyperlipidemia in RA. The long term goals include the development of a foundation to conduct a pragmatic trial of this intervention (and future studies) in collaboration with ArthritisPower. We will incorporate other modifiable CVD risk factors such as hypertension not only targeted to RA patients but to other rheumatic diseases and other vexing challenges in rheumatology such as medication/treatment adherence.

项目摘要 风湿病学最伟大的成功故事之一-类风湿性关节炎（RA）缓解的成就- 由于RA患者的评估和治疗严重不足， 心血管疾病（CVD）风险。该项目将为一项干预措施奠定基础， 假设以患者为中心的干预措施适合于我将发展为 部分K23将改善RA的高脂血症筛查和治疗，从而降低CVD风险。 对于K23和未来的项目，我们将建立在亚拉巴马大学伯明翰分校（UAB）的基础上， 与以患者为中心的成果研究所（PCARI）资助的关节炎患者力量合作 Powered Research Network（PPRN）我们将与ArthritisPower > 2，000 RA的成员合作 美国50个州的患者和护理人员。在这个提议中，我们将开发和测试一种新的 理论驱动（使用班杜拉的社会认知理论），以患者为中心的教育决策支持/同行 辅导干预，从而掌握发展和实施患者的基本技能， 介入研究。这项建议的目的是： 目的1：确定RA患者和医生降低CVD风险的障碍。在此期间，我们将应用 定性方法，以了解有关CVD和CVD风险降低的态度，信念和障碍。 目的2：开发一种旨在优化RA患者血脂筛查和管理的干预措施。我们 将根据目标1中收集的数据制定干预措施。这将包括病人教育和 决策支持程序，以促进高脂血症筛查或开始降脂治疗（LLT） （主要结果）和自我效能在采取降脂治疗和患者激活（次要结果）。 目标3：对目标2中制定的干预措施进行试点测试。在此期间，我们将应用与以下方面相关的方法： 临床试验，以测试新开发的干预措施的可行性。 这项研究将导致以患者为中心的干预，以促进解决以下差距所需的第一步： RA高脂血症的筛查和管理。长期目标包括发展一个 基金会将与以下机构合作，对这种干预措施（以及未来的研究）进行务实的试验： 关节炎的力量。我们将纳入其他可改变的心血管疾病风险因素，如高血压，不仅针对 风湿性关节炎患者，但其他风湿性疾病和其他令人烦恼的挑战，如 药物/治疗依从性。