Multidisciplinary Approach to Patient- physician Partnership In treating to Target in Rheumatoid Arthritis (MAPPIT-RA)

Despite established guidelines for Rheumatoid Arthritis (RA) management in patients with suboptimal targets, therapeutic intensification does not occur as frequently as expected; potential reasons include that physicians and patients often differ in their assessments of disease activity, parameters shaping physicians’ assessments vary, and may not resonate with the patients’ perspectives or beliefs of adequate disease control. This may be particularly relevant to Hispanics, the most rapidly expanding ethnic group in the US, incurring unique clinical features, treatment delays, higher disease severity and worse functional outcomes, further compounded by poor health literacy, delayed access to care, low acculturation and sparse resource utilization. Patient education on determinants of long-term disability, and a better physician grasp of the patient perspective will foster shared decision-making and adherence to the treat to target (T2T) principles. This proposal aspires to introduce and pilot an integrated, multidisciplinary, patient-centered RA intervention model that capitalizes on a partnership between the patient and the extended Rheumatology Health care team, in order to promote understanding, uptake and adherence to the principles of T2T.
Our Intervention will incorporate a culturally tailored and relevant disease- education framework including goal establishment and tracking, a delivery component capitalizing on interpersonal interaction and a trusting relationship with the care team, prompt evaluation and management of depression, stress and pain coping, physical and behavioral activation, positive thinking, self resilience, and self-empowerment. We aim to empower patients to re-evaluate their outlook on quality of life, enhance their social function, and re-introduce them into the active work force.