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

Purpose:

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.

Method:

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.

Results:

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."

Conclusion:

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
DOI: 10.1002/art.26935

Abstract Supplement

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2009 ACR/ARHP