Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement

Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.


Does an RA Peer Support Program Impact Disease Outcomes?

Zibit3,  Melanie, Cui4,  Jing, Iannaccone2,  Christine K., Shadick1,  Nancy A., Weinblatt1,  Michael E., Courtney3,  Meghan, Hanlan3,  Margo

Brigham & Womens Hospital, Boston, MA
Brigham and Woemens Hospital, Boston, MA
Brigham and Women's Hospital, Boston, MA
Brigham and Womens Hospital, Boston, MA

Purpose:

A diagnosis of RA can lead to loss of function, increased pain, depression, and complex medical care. Peer support, used effectively in other illnesses, may provide support that can lead to improvement in RA disease outcomes. This pilot study evaluates whether a peer support program for RA patients can improve fatigue, pain, functional status, self-efficacy, emotional health, and medication adherence.

Methods:

RA patients at a hospital arthritis clinic seeking peer support enrolled in a peer support program. Patients wishing to provide support to others (mentors) were trained by a social worker to learn how to help other patients with concerns, coping strategies and medical decision-making. Mentors and mentees were partnered based on age, disease duration, co-morbidities, lifestyle, physical activity, and employment status. Mentors contacted mentees by phone once a week for 6 weeks, with some email or a face-to-face meetings. To evaluate the efficacy of the program, mentees seeking support were compared with controls from an RA registry at baseline and at 6 month follow up. Both groups filled out questionnaires concerning fatigue and pain (VAS), flares, self-efficacy(Arthritis Self-Efficacy), emotional health and functional status (SF12 Health Status Survey), and medical adherence (ASK20). Univariate analyses were done to compare both groups at baseline and a linear regression model was used to compare differences after 6 months.

Results:

10 mentees and 6 controls, to date, have completed baseline and 6 month questionnaires. There were no differences in disease duration (p=0.98) and gender (P=0.89), but age distribution differed (p=0.02) between mentees and controls. Analysis at 6 months, using linear regression analyses, showed that mentees had a significant improvement in self-efficacy compared to the controls (p=0.05) (see Table 1). Subjects completing the program to date showed a trend toward less fatigue (p=0.11) and improvements in medical adherence (p=0.12).

Conclusions:

This pilot study suggests that RA patients who have active disease and receive peer support show improvement in self-efficacy. Peer support programs may be effective in enhancing patients' coping skills. Further analyses are needed to demonstrate the impact of the program on patient self-reported outcomes of fatigue and medical adherence.

Table 1. Linear Regression Analysis Mentees (N=10) compared to Controls (N=6)

Age
20–453 (30%)0
46–552 (20%)5 (83.3%)
>555 (50%)1 (16.7%)
Disease duration
mean (±SD)15.6 (12.28)15.7 (12.36)
median14.5 (1–37)17 (0–36)
Gender (female)9 (90%)6 (100%)
 MenteesControls 
 Pre Mean (± SD)Pre Mean (± SD)Post Mean (± SD)Pre Mean (± SD)P
Self-efficacy53.52 (± 21.56)64.26 (± 16.75)81.11 (± 14.32)74.44 (± 9.87)0.05
Fatigue (0–100)55.5 (± 34.36)56 (± 29.04)29.17 (± 26.35)51.67 (± 28.75)0.11
Medical Adherence ASK20 (20–100)42.9 (± 13.37)39.1 (± 8.58)35.7 (± 13.54)39.7 (± 10.46)0.12
Pain (0–100)61.5 (± 25.5)60.5 (± 24.77)30 (± 33.62)45.0 (± 25.50)0.22
SF-12 (MCS)44.19 (± 12.22)45.39 (± 14.65)54.44 (± 4.26)52.30 (± 9.36)0.91
SF-12 (PCS)31.08 (± 12.00)34.83 (± 16.36)48.00 (± 13.20)40.38 (± 14.85)0.35

To cite this abstract, please use the following information:
Zibit, Melanie, Cui, Jing, Iannaccone, Christine K., Shadick, Nancy A., Weinblatt, Michael E., Courtney, Meghan, et al; Does an RA Peer Support Program Impact Disease Outcomes? [abstract]. Arthritis Rheum 2010;62 Suppl 10 :1335
DOI: 10.1002/art.29101

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