Effect of communicating personalized rheumatoid arthritis risk on concern for developing RA: A randomized controlled trial. Issue 5 (May 2019)

• Record Type: Journal Article
• Authors: Marshall, Allison A.; Zaccardelli, Alessandra; Yu, Zhi; Prado, Maria G.; Liu, Xinyi; Miller Kroouze, Rachel; Kalia, Sarah S.; Green, Robert C.; Triedman, Nellie A.; Lu, Bing; Deane, Kevin D.; Iversen, Maura D.; Karlson, Elizabeth W.; Sparks, Jeffrey A.
• Is Part Of: Patient education and counseling. Volume 102:Issue 5(2019)
• Page Start: 976
• Page End: 983
• Publication Date: 2019-05
• Subjects: Personalized medicine -- Genetics -- Concern -- Rheumatoid arthritis -- Prevention; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2018.12.011
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: This trial compared disclosure of chronic disease risk to a standard strategy. Personalized risk disclosure lowered concern for developing chronic disease. Disclosing personalized chronic disease risk may provide reassurance to those at risk. Abstract: Objective: To investigate the effect of providing comprehensive personalized risk information on concern for chronic disease development. Methods: Unaffected first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients (n = 238) were randomly allocated to: 1) disclosure of RA risk personalized to demographics, genetics, biomarkers, and behaviors using a web-based tool (PRE-RA arm, n = 78); 2) PRE-RA with interpretation by a health educator (PRE-RA Plus arm, n = 80); and 3) standard RA education (Comparison arm, n = 80). Concern for developing RA was assessed at baseline and immediately, 6 weeks, 6 months, and 12 months post-intervention. Results: FDRs randomized to PRE-RA arms were less concerned about developing RA than the Comparison arm at all post-intervention assessments (p < 0.05). Among those concerned about RA risk at baseline, the PRE-RA (OR = 4.7, 95%CI 1.5–14.4) and PRE-RA Plus (OR = 5.2, 95%CI 1.6–17.3) arms were more likely to have reassurance 6 months post-intervention than the Comparison arm. Conclusion: A comprehensive tool provided reassurance to those at risk for developing a chronic disease, with or without interpretation from a health educator, compared to standard education. Practice implications: Individuals may be more likely to be reassured using a personalized chronic disease risk disclosure tool than a standard non-personalized approach.