September 29, 2020 | Erin Bluvas, bluvase@sc.edu
Scientists within the Department of Health Services Policy and Management (HSPM) are walking the talk when it comes patient-centered care. Led by assistant professor Melanie Cozad, the team* recently won its second Pfizer Independent Learning and Change grant to collaborate with patients in improving physician-patient communication through the development of a patient-designed mobile app [photo above shows the researchers and patients who collaborated on the project].
This is tool designed by patients with rheumatoid arthritis for patients with rheumatoid arthritis.
-Melanie Cozad, assistant professor of health services policy and management
In 2017, Cozad won nearly $300K from the biopharmaceutical company to enhance shared decision making between physicians and individuals with rheumatoid arthritis by creating a personalized, patient-specific preference tool. In partnership with Prisma Health rheumatologist Gulzar Merchant, the researchers collaborated so closely with patients that the resulting mobile application, RunRA, is truly patient-designed.
“This is tool designed by patients with rheumatoid arthritis for patients with rheumatoid arthritis,” Cozad says. “It enables patients to share a more holistic picture about themselves with their rheumatologist and reduce perceived barriers by improving physician-patient communication – moving the patient from a passive to active participant in the clinical management of their rheumatoid arthritis.”
Earlier this year, Pfizer awarded Cozad and her team another $346K to evaluate the effectiveness of RunRA, which allows patients to track their disease progression, goals and therapeutic success between office visits. In this phase of the project, the researchers will continue working with patients to assess the effectiveness of the app to achieve these aims. They will also evaluate the app’s potential to improve patient-provider communication, adherence to therapy, and outcomes. This evidence will provide insight into how effective mobile technology can be in managing rheumatoid arthritis thereby assisting with its translation into widespread practice.
Like many chronic conditions, rheumatoid arthritis does not have a cure, making both its day-to-day and long-term management critical for health and quality of life. With the emergence of new treatment options (e.g., aggressive, multiple drug therapies) over the past few years, clear communication about goals and priorities are especially important for this population. These new treatments can have differential effects on pain control, mobility, fatigue, joint deformity management, and symptoms.
Miscommunication between a patient and the rheumatologist also can lead to the selection of a therapeutic strategy that does not fit with a patient’s lifestyle, resulting non-adherence to treatment.
-Melanie Cozad, assistant professor of health services policy and management
Using a patient-centered care approach helps ensure that treatment is tailored to patients’ goals by focusing on individual lifestyles and priorities. This alignment yields more successful disease management and, in turn, better quality of life for patients.
Prior to this project, there were no support tools to help patients express their goals to their rheumatologist during the clinical visit. Based on their previous research, the team learned that patients found it challenging to capture and describe their symptoms and side-effects because they would often appear and subside between visits. They also expressed difficulty in remembering the exact timing and severity of symptoms and side effects.
“These challenges caused patients to lack confidence when communicating with their rheumatologist, leading to anxiety when it was time for therapeutic changes,” Cozad explains. “Miscommunication between a patient and the rheumatologist also can lead to the selection of a therapeutic strategy that does not fit with a patient’s lifestyle, resulting non-adherence to treatment.”
Explaining a chronic health condition should not feel like a speed dating event.
-Melanie Cozad, assistant professor of health services policy and management
The overall goal of the project is to improve shared decision making, treatment adherence
and disease burden while reducing decision conflict. The researchers will ask one
group of study participants to utilize and provide feedback about the app so that
they can compare their experiences to a second group of participants who receive current
standard care for rheumatoid arthritis.
“Explaining a chronic health condition should not feel like a speed dating event,”
Cozad says. “Yet, patients with rheumatoid arthritis report feeling pressure to quickly
communicate the complexity of their condition as well as what is important to them
in managing it to their rheumatologist. With the development of this data collection
tool and its integration into clinical care, we hope to help patients be active participants
in the discussion with their healthcare provider about the treatment options that
are right for them.”
The researchers are still looking for individuals with rheumatoid arthritis to participate in the study to evaluate RunRA. To learn more, visit our study web page, Facebook pageor contact Ms. Anna Nourse, Project Coordinator, at ANOURSE@greenvillemed.sc.edu
*Collaborators include Melanie Cozad (HSPM), Ronnie Horner (HSPM), Lisa Lindley (University
of Tennessee), Gulzar Merchant (Prisma Health-Upstate), Anna Nourse (SOMG), Alicia
Oostdyk (HSPM), Masroora Tabassum, (HSPM), Nyrobi Tyson (Epidemiology)
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