Perspectives of Patients and Healthcare Providers on a Shared Decision-Making Dashboard in Rheumatoid Arthritis Care
Author(s)
Swasti D. Soekhradj, MSc1, Marc R. Kok, Dr.2, Fabiënne Nederpelt, MSc.3, Harald E. Vonkeman, Prof. Dr.4, Angelique Weel-Koenders, MSc, PhD, MD5, Deirisa Lopes Barreto, Dr.6.
1Rheumatology and Clinical Immunology, Maasstad Ziekenhuis & Erasmus School of Health Policy & Management, Rotterdam, Netherlands, 2Rheumatology and Clinical Immunology, Maasstad Ziekenhuis, Rotterdam, Netherlands, 3Erasmus School of Health Policy & Management, Rotterdam, Netherlands, 4Rheumatology and Clinical Immunology & Psychology, Health and Technology, Medisch Spectrum Twente & University of Twente, Enschede, Netherlands, 5Erasmus University & Maasstad Hospital, Rotterdam, Netherlands, 6Maasstad Hospital & Erasmus School of Health Policy & Management, Rotterdam, Netherlands.
1Rheumatology and Clinical Immunology, Maasstad Ziekenhuis & Erasmus School of Health Policy & Management, Rotterdam, Netherlands, 2Rheumatology and Clinical Immunology, Maasstad Ziekenhuis, Rotterdam, Netherlands, 3Erasmus School of Health Policy & Management, Rotterdam, Netherlands, 4Rheumatology and Clinical Immunology & Psychology, Health and Technology, Medisch Spectrum Twente & University of Twente, Enschede, Netherlands, 5Erasmus University & Maasstad Hospital, Rotterdam, Netherlands, 6Maasstad Hospital & Erasmus School of Health Policy & Management, Rotterdam, Netherlands.
OBJECTIVES: Shared decision-making (SDM) promotes patient-centered care, crucial for chronic diseases like rheumatoid arthritis (RA). An SDM dashboard combining patient-reported outcome measures (PROMs) with clinical data may benefit RA care, especially patients with limited health literacy (LHL) who face challenges engaging in decision-making. This study identifies barriers and facilitators affecting use, usability, and adoption of an SDM dashboard from RA patients with LHL and healthcare providers’ (HCPs) perspectives.
METHODS: An explanatory sequential mixed-methods approach was conducted at Maasstad Hospital. RA patients were recruited through purposive and convenience sampling based on lower socioeconomic status. During consultations, HCPs referred eligible patients to a researcher for face-to-face communication. Participants completed demographic, health forms, and the Health Literacy Questionnaire (HLQ), either independently or with assistance. Inclusion required scores between 3 and 10 across nine literacy domains. HCPs were recruited similarly during multidisciplinary meetings and completed an intake form plus the Unified Theory of Acceptance and Use of Technology (UTAUT) survey. Quantitative data were analyzed descriptively and by cluster analysis. Focus groups with patients and HCPs were conducted and analyzed thematically.
RESULTS: Twelve RA patients participated (58% female), with 42% low and 58% intermediate education. HLQ analysis showed moderate to low health literacy, especially in appraising (mean=2.3) and understanding health information (mean=2.6). Thirteen HCPs (85% female, 62% physicians) strongly supported the dashboard, showing high performance expectancy, effort expectancy, facilitating conditions, and low anxiety on UTAUT. Patient focus groups identified barriers including low digital literacy, language, complex PROMs, and technical issues. Patients valued empowerment and social support. HCPs noted similar barriers plus organizational challenges like incomplete data and time constraints. Both groups prioritized simplifying PROMs, improving communication, reducing time pressure, and better workflow integration.
CONCLUSIONS: RA patients with LHL and HCPs value the SDM dashboard for improving care. Addressing multilevel barriers is essential to enhance usability and adoption in rheumatology.
METHODS: An explanatory sequential mixed-methods approach was conducted at Maasstad Hospital. RA patients were recruited through purposive and convenience sampling based on lower socioeconomic status. During consultations, HCPs referred eligible patients to a researcher for face-to-face communication. Participants completed demographic, health forms, and the Health Literacy Questionnaire (HLQ), either independently or with assistance. Inclusion required scores between 3 and 10 across nine literacy domains. HCPs were recruited similarly during multidisciplinary meetings and completed an intake form plus the Unified Theory of Acceptance and Use of Technology (UTAUT) survey. Quantitative data were analyzed descriptively and by cluster analysis. Focus groups with patients and HCPs were conducted and analyzed thematically.
RESULTS: Twelve RA patients participated (58% female), with 42% low and 58% intermediate education. HLQ analysis showed moderate to low health literacy, especially in appraising (mean=2.3) and understanding health information (mean=2.6). Thirteen HCPs (85% female, 62% physicians) strongly supported the dashboard, showing high performance expectancy, effort expectancy, facilitating conditions, and low anxiety on UTAUT. Patient focus groups identified barriers including low digital literacy, language, complex PROMs, and technical issues. Patients valued empowerment and social support. HCPs noted similar barriers plus organizational challenges like incomplete data and time constraints. Both groups prioritized simplifying PROMs, improving communication, reducing time pressure, and better workflow integration.
CONCLUSIONS: RA patients with LHL and HCPs value the SDM dashboard for improving care. Addressing multilevel barriers is essential to enhance usability and adoption in rheumatology.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
PCR186
Topic
Patient-Centered Research
Topic Subcategory
Instrument Development, Validation, & Translation, Patient Behavior and Incentives, Patient Engagement, Patient-reported Outcomes & Quality of Life Outcomes
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal), No Additional Disease & Conditions/Specialized Treatment Areas