Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
An Innovative Support and Education Program for Early and Newly Diagnosed RA Patients: Emerging Themes
Kurtz, D., Batterman, A., Horton, R., Leff, L., Reyes-Canu, J., Fields, T., Paget, Stephen
Present treatment models in RA emphasize early medical intervention. Similarly, research indicates that early psychosocial interventions may positively affect long-term functional status and adaptive coping (Evers et al, 2003, Dobkin et al, 2008). Previously we reported on a needs assessment of newly diagnosed (<1year) RA patients which indicated the need for an education and support program to meet their specific psychosocial needs. Based on these results, we designed a unique program within a hospital based early arthritis center. We report now on salient themes that have emerged two years after the program's implementation.
The program was developed using data from a multi-level needs assessment and modeled after a successful program for patients with chronic RA. 16 monthly workshops were convened as a forum for newly diagnosed patients to gain essential RA-related information and to have access to peer support. 4 series consisting of 4 sessions each have met to date. Each featured a lecture by an RA expert and a support group co-facilitated by an MSW and RN. Topics included: Drugs in early treatment, coping skills, joint protection and nutrition. After each session, structured written evaluations with Likert-type and open-ended questions were given to assess program impact. Focus groups were also held to elicit participant feedback and inform future planning.
114 evaluations were completed from an average of 10 participants per session. Demographics. Gender: 75% f, 25% m. Ethnicity: African American 25%, Asian American 6%, Caucasian 63%, Latino 6%. Mean age: 49.6 yrs. Education: 94% college or higher. 89% agreed ("completely" or "a great deal") they were satisfied with group discussions. 92% agreed ("completely" or "a great deal") that the "group is relevant to daily coping with RA." Salient themes were: new awareness of the importance of early, aggressive treatment; need to address the psychosocial impact of RA; need for social support and improved MD/patient communication. The following patient statements are illustrative of these themes: "I will consider biologics sooner rather than later,""I recognize that depression needs to be addressed and not ignored,""Others deal with the same issues,""This group is helpful in bringing out emotions I had been repressing,""I will talk to my doctor about how to best evaluate [treatment] progress."
Current research and our 2 year program experience lead us to believe that discussion of these themes in a structured setting soon after diagnosis offers a window of opportunity for cognitive reframing, which can enhance adaptive coping. This type of intervention is an integral part of a comprehensive treatment plan for the newly diagnosed patient and may serve to inform others in implementing similar programs.
To cite this abstract, please use the following information:
Kurtz, D., Batterman, A., Horton, R., Leff, L., Reyes-Canu, J., Fields, T., et al; An Innovative Support and Education Program for Early and Newly Diagnosed RA Patients: Emerging Themes [abstract]. Arthritis Rheum 2009;60 Suppl 10 :1861