Personalised care packages for people with rheumatoid arthritis: a mixed-methods study.

Dey, Mrinalini; Busby, Amanda; Isaac, John; Pratt, Arthur; Ndosi, Mwidimi; Young, Adam; Lempp, Heidi; Nikiphorou, Elena

Abstract

Disease management in rheumatoid arthritis (RA) requires holistic assessment. We aimed to design personalised care packages suitable for people with RA. This study was conducted using a mixed-methods approach and exploratory sequential design. Consensus workshops were held, involving people with RA and healthcare professionals (HCPs) treating them. Subsequently, an online survey sought views on future care packages for people with RA at relevant disease progression/stages, based on (1) results from previous quantitative data analyses (eg, socioeconomic/clinical factors), and (2) themes identified during workshops. Two conceptual care pathways were identified: (1) around the time of RA diagnosis, an early opportunity to influence the disease course; (2) for individuals with established RA, emphasising the importance of 'the right MDT member at the right time'.Three care packages were suggested: (1) early care package (around RA diagnosis): introduction to MDT; (2) continuity of care package (established RA): primary/secondary providers; and (3) personalised holistic care package: integral to packages 1 and 2, implemented alongside allied health professionals.The survey received 41 responses; 82.9% agreed that people with RA need a consistent 'early care package' at diagnosis. 85.4% approved of additional care packages tailored to individuals' clinical, psychological and social needs when moving to different stages of their long-term disease. Fleiss' Kappa calculations demonstrated fair level of agreement among respondents. Two care pathways, with three tailored care packages, were identified, with potential to improve management of people with RA. Future research will help to determine if such care packages can impact clinical (including patient-reported) outcomes. [Abstract copyright: © Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]

• Journal Article Type: Article
• Acceptance Date: Nov 24, 2023
• Online Publication Date: Jan 8, 2024
• Publication Date: Jan 8, 2024
• Deposit Date: Jan 10, 2024
• Publicly Available Date: Jan 11, 2024
• Journal: RMD Open
• Electronic ISSN: 2056-5933
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 10
• Issue: 1
• Article Number: e003483
• DOI: https://doi.org/10.1136/rmdopen-2023-003483
• Keywords: Patient Reported Outcome Measures, Health Personnel, Research Design, Qualitative research, Critical Pathways, Humans, Rheumatoid Arthritis, Patient Care Team, Arthritis, Rheumatoid - diagnosis - therapy
• Public URL: https://uwe-repository.worktribe.com/output/11598641
• Publisher URL: https://rmdopen.bmj.com/content/10/1/e003483