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      Comparing reactions to written leaflets, online information and real-time Doppler images among South Asian patients with rheumatoid arthritis

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          Abstract

          Objective

          There is poor adherence to medication in patients of South Asian origin with RA. There are limited numbers of interventions to improve patient engagement. The objective of this study was to explore how patients of South Asian origin make sense of their disease after receiving written leaflets compared with online information or visualizing real-time Doppler US images of their inflamed joints.

          Methods

          Patients of South Asian origin with RA were recruited from two National Health Service hospitals in the West Midlands, UK. In-depth semi-structured interviews were undertaken after exposure to vignettes designed to elicit patients’ perspectives on: written leaflets; online information to complement face-to-face interaction with health-care professionals; and Doppler US during the early stages of the disease journey. Data were analysed thematically until data saturation was reached in 20 individuals.

          Results

          The responses to vignette scenarios were described by the patients. Overall, patients found real-time Doppler US more valuable in understanding RA and RA medications compared with other methods. Patients reported that Doppler US reduced anxiety and helped to address misconceptions about the long-term disease and its ability to be controlled.

          Conclusion

          We have developed new understanding regarding the educational utility of a Doppler US session in patients of South Asian origin and how these sessions can be optimized to increase patient engagement and adherence to medication.

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          Most cited references19

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          Changing illness perceptions after myocardial infarction: an early intervention randomized controlled trial.

          This study was designed to examine whether a brief hospital intervention designed to alter patients' perceptions about their myocardial infarction (MI) would result in a better recovery and reduced disability. In a prospective randomized study, 65 consecutive patients with their first MI aged were assigned to receive an intervention designed to alter their perceptions about their MI or usual care from rehabilitation nurses. Patients were assessed in hospital before and after the intervention and at 3 months after discharge from hospital. The intervention caused significant positive changes in patients' views of their MI. Patients in the intervention group also reported they were better prepared for leaving hospital (p<.05) and subsequently returned to work at a significantly faster rate than the control group (p<.05). At the 3-month follow-up, patients in the intervention group reported a significantly lower rate of angina symptoms than control subjects (14.3 vs. 39.3, p<.03). There was no significant differences in rehabilitation attendance between the two groups. An in-hospital intervention designed to change patients' illness perceptions can result in improved functional outcome after MI.
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            Why illness perceptions matter

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              Patient preferences for psychological support in inflammatory arthritis: a multicentre survey.

              Inflammatory arthritis (IA) can lead to anxiety, depression, pain and fatigue. Psychological support can improve quality of life and self-management; and European and American guidelines recommend support be offered. This study examined patient views on psychological support for their IA.
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                Author and article information

                Journal
                Rheumatol Adv Pract
                Rheumatol Adv Pract
                rheumap
                Rheumatology Advances in Practice
                Oxford University Press
                2514-1775
                2020
                24 March 2020
                24 March 2020
                : 4
                : 1
                : rkaa009
                Affiliations
                [r1 ] Insitute of Clinical Sciences, University of Birmingham , Birmingham
                [r2 ]Division of Psychology and Mental Health, Manchester Centre for Health Psychology, School of Health Sciences , University of Manchester
                [r3 ] Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester
                [r4 ] Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trusts, Wolverhampton , UK
                [r5 ] Department of Rheumatology, Westmead Hospital , Westmead, NSW, Australia
                Author notes
                Correspondence to: Kanta Kumar, University of Birmingham, Birmingham B15 2TT, UK. E-mail: k.kumar@ 123456bham.ac.uk
                Article
                rkaa009
                10.1093/rap/rkaa009
                7293862
                32551414
                fa9d6455-fa9f-4d54-9830-ed4c06c24a6b
                © The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 28 October 2019
                : 6 March 2020
                Page count
                Pages: 9
                Funding
                Funded by: Health Education England, Royal College of Nursing and Mary Seacole;
                Categories
                Original Article

                rheumatoid arthritis,doppler ultrasound scan,ethnicity,illness perceptions,medication adherence

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