Effects of a Web‐Based Patient Decision Aid on Biologic and Small‐Molecule Agents for Rheumatoid Arthritis: Results From a Proof‐of‐Concept Study

Objectives: To assess the extent to which ANSWER-2, an interactive online patient decision aid, reduces patients' decisional conflict and improves their medication-related knowledge and self-management capacity. Methods: We used a pre-post study design. Eligible participants had a diagnosis of rheumatoid arthritis (RA), had been recommended to start using a biologic or small molecule agent or to switch to a new one, and had Internet access. Access to ANSWER-2 was provided immediately after enrollment. Outcome measures included: 1) Decisional Conflict Scale (DCS), 2) Partners in Health Scale (PIHS), and 3) Medication Education Impact Questionnaire (MeiQ). Paired t-test was used to assess differences pre and post intervention. Results: Of 50 participants, 40 were women with a mean age of 49.6 years (SD: 12.2). The median disease duration was 5 years (Quartile 1; Quartile 3: 2; 10). The mean DCS was 45.9 (SD: 25.1) pre-intervention and 25.1 (SD: 21.8) post-intervention (change: -21.2, 95% CI: -28.1, -14.4; p < 0.001). Before using ANSWER-2, 20% of participants scored < 25, compared to 52% after the intervention. Similar results were observed in the PIHS (pre: 25.3, SD: 14.8; post: 20.4, SD: 13.0; change: -3.7, 95% CI: -6.3, -1.0; p = 0.009). Findings from the MeiQ were mixed, with statistically significant differences found only in the self-management sub-scales. Conclusion: Patients' decisional conflict decreased and perceived self-management capacity improved after using ANSWER-2. Future research comparing the effectiveness of ANSWER-2 with educational material on biologics will provide further insight into its value in RA management. This article is protected by copyright. All rights reserved.