Optimization of hyperlipidemia management among patients with rheumatoid arthritis: A patient-centered intervention development

类风湿关节炎患者高脂血症管理的优化：以患者为中心的干预措施发展

• 批准号: 10176414
• 负责人: Iris Y Navarro-Millán
• 金额: $ 17.12万
• 依托单位: WEILL MEDICAL COLL OF CORNELL UNIV
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2022-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10176414
• 关键词: Achievement; Active Learning; Address; Affect; Alabama; Arthritis; Attention; Attitude; Award; Belief; Cardiovascular Diseases; Caregivers; Caring; Cause of Death; Cholesterol; Chronic; Chronic Disease; Clinical Trials; Collaborations; Communities; Data; Databases; Decision Making; Development; Diabetes Mellitus; Disease; Disease remission; Education; Focus Groups; Foundational Skills; Foundations; Funding; Future; Geographic state; Goals; Health Insurance; Health behavior; Human; Hyperlipidemia; Hypertension; Individual; Institution; Intervention; Intervention Studies; Intervention Trial; Lipids; Low-Density Lipoproteins; Medical; Mentors; Methods; Nature; Patient Education; Patient Outcomes Assessments; Patient-Focused Outcomes; Patients; Persons; Pharmaceutical Preparations; Pharmacists; Physicians; Population; Primary Care Physician; Program Evaluation; Qualitative Methods; Qualitative Research; Randomized; Research; Research Activity; Research Institute; Research Methodology; Research Personnel; Research Training; Rheumatism; Rheumatoid Arthritis; Rheumatology; Risk; Risk Factors; Risk Management; Risk Reduction; SECTM1 gene; Self Administration; Self Efficacy; Self-Direction; Telephone; Testing; Training; Training Activity; Universities; Work; base; cardiovascular disorder risk; cardiovascular risk factor; career; design; evidence base; feasibility testing; high risk; improved; insurance claims; member; novel; patient oriented; peer coaching; peer support; pragmatic trial; primary outcome; programs; recruit; relative effectiveness; rheumatologist; screening; secondary outcome; shared decision making; skills; social cognitive theory; success; theories; therapy design; therapy development; tool; treatment adherence

Project Summary One of the greatest success stories in rheumatology - the achievement of rheumatoid arthritis (RA) remission - is tempered by the fact that individuals with RA are dramatically under evaluated and under treated to reduce cardiovascular disease (CVD) risk. This project will build the foundation for an intervention that will test the hypothesis that the patient-centered intervention tailored to the RA population that I will develop as part of this K23 will improve hyperlipidemia screening and treatment in RA, thereby reducing CVD risk. For the K23 and future projects, we will build on the University of Alabama at Birmingham (UAB)'s collaboration with the Patient-Centered Outcomes Research Institute (PCORI)-funded ArthritisPower Patient Powered Research Network (PPRN). We will work in partnership with members of ArthritisPower >2,000 RA patients and caregivers in all 50 US states. In this proposal, we will develop and test the feasibility of a novel theory-driven (Using Bandura's Social Cognitive Theory), patient-centered educational decision support/peer coaching intervention, thereby mastering foundational skills in the development and implementation of patient- engaged intervention research. The aims of this proposal are: Aim 1: To identify patient and physician barriers to CVD risk reduction in RA. During this aim, we will apply qualitative methods to elicit attitudes, beliefs and barriers regarding CVD and CVD risk reduction. Aim 2: To develop an intervention designed to optimize lipid screening and management in RA patients. We will build the intervention based on the data collected in Aim 1. This will consist of patient education and a decision support program to facilitate screening for hyperlipidemia or initiation of lipid lowering therapy (LLT) (primary outcome) and self-efficacy in taking lipid lowering therapy and patient activation (secondary outcome). Aim 3: To pilot test the intervention developed in Aim 2. During this aim, we will apply methods related to clinical trials to test the feasibility of the newly developed intervention. This study will result in a patient-centered intervention to facilitate the first steps needed to address the gap in screening and management of hyperlipidemia in RA. The long term goals include the development of a foundation to conduct a pragmatic trial of this intervention (and future studies) in collaboration with ArthritisPower. We will incorporate other modifiable CVD risk factors such as hypertension not only targeted to RA patients but to other rheumatic diseases and other vexing challenges in rheumatology such as medication/treatment adherence.

项目摘要 风湿病学上最大的成功案例之一 - 类风湿关节炎（RA）缓解的成就 - 由于RA患者的评估很大和治疗以减少 心血管疾病（CVD）风险。该项目将为干预措施奠定基础，以测试 假设我将根据RA人群量身定制的以患者为中心的干预措施我将发展为 该K23的一部分将改善RA中的高脂血症筛查和治疗，从而降低CVD风险。 对于K23和未来的项目，我们将在伯明翰（UAB）的阿拉巴马大学建立 与以患者为中心的结果研究所（PCORI）资助的关节炎患者合作 动力研究网络（PPRN）。我们将与关节炎的成员合作> 2,000 RA 美国所有50个州的患者和看护人。在此提案中，我们将开发和测试小说的可行性 理论驱动（使用班杜拉的社会认知理论），以患者为中心的教育决策/同伴 教练干预，从而掌握患者发展和实施的基础技能 - 参与干预研究。该提案的目的是： 目标1：确定RA中CVD风险降低的患者和医师障碍。在此目标中，我们将申请 关于CVD和CVD风险降低的态度，信念和障碍的定性方法。 目标2：开发旨在优化RA患者脂质筛查和管理的干预措施。我们 将根据AIM 1中收集的数据建立干预措施。这将包括患者教育和 决策支持计划，以促进筛查高脂血症或开始脂质降低治疗（LLT） （主要结果）和自我效能感在降低脂质降低治疗和患者激活（次要结果）方面。 目标3：试点测试目标2中开发的干预措施。在此目标期间，我们将采用与 临床试验以测试新开发的干预措施的可行性。 这项研究将导致以患者为中心的干预措施，以促进解决差距所需的第一步 RA中高脂血症的筛查和管理。长期目标包括开发 与与此干预（以及未来研究）合作进行务实试验的基础 关节炎。我们将结合其他可修改的CVD风险因素，例如高血压，不仅针对 RA患者，但针对其他风湿性疾病和风湿病学中的其他烦恼挑战 药物/治疗依从性。