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Perrot S, Roucoux G, Bertin P, Beauvais C, Alliot-Launois F, Chassany O, Duracinsky M. Cross-perspectives on care pathways for painful osteoarthritis: A qualitative analysis in patients and healthcare professionals. Musculoskeletal Care 2023; 21:1142-1153. [PMID: 37404113 DOI: 10.1002/msc.1795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/06/2023]
Abstract
PURPOSE To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA). PATIENTS AND METHODS We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management. RESULTS Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs. CONCLUSION The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.
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Affiliation(s)
- Serge Perrot
- Pain Center, INSERM U987, Hôpital Cochin, Université Paris Cité University, Paris, France
| | - Guillaume Roucoux
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
- ECEVE, INSERM UMR 1123, Paris Cité University, Paris, France
| | - Philippe Bertin
- Rheumatology Department, University Hospital, Limoges, France
| | | | | | - Olivier Chassany
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
| | - Martin Duracinsky
- Patient-Reported Outcomes Unit (PROQOL), Health Economics Clinical Trial Unit (URC-ECO), Hotel-Dieu Hospital, AP-HP, Paris, France
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2
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Beauvais C, Pereira B, Pham T, Sordet C, Claudepierre P, Fayet F, Wendling D, Costantino F, Carton L, Grange L, Soubrier M, Legoupil N, Perdriger A, Tavares I, Dernis E, Gossec L, Rodère M. Development and Validation of a Self-Administered Questionnaire Measuring Essential Knowledge in Patients With Axial Spondyloarthritis. J Rheumatol Suppl 2023; 50:56-65. [PMID: 35840152 DOI: 10.3899/jrheum.211314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To develop and validate a patient knowledge questionnaire regarding axial spondyloarthritis (axSpA). METHODS Knowledge considered essential for patients with axSpA was identified through Delphi rounds among rheumatologists, healthcare professionals (HCPs), and patients, then reformulated to develop the knowledge questionnaire. Cross-sectional validation was performed in 14 rheumatology departments to assess internal validity (Kuder-Richardson coefficient), external validity, acceptability, reproducibility (Lin concordance correlation coefficient), and sensitivity to change (knowledge score before vs after patient education sessions and effect size). RESULTS The Spondyloarthritis Knowledge Questionnaire (SPAKE) is a self-administered 42-item questionnaire with a 32-item short form, both scored 0 to 100, assessing knowledge of disease, comorbidities, pharmacological treatments, nonpharmacological treatments, self-care, and adaptive skills. In the validation study (130 patients; 67 [51.5%] male, mean age 43.5 [SD 12.9] yrs), the mean (SD) score of the long-form questionnaire was 71.6 (15.4), with higher scores (better knowledge) in nonpharmacological treatments and adaptive skills and lower scores in cardiovascular comorbidity and pharmacological treatments. Acceptability was good, with no missing data; the internal validity coefficient was 0.85. Reproducibility was good (0.81, 95% CI 0.72-0.89). SPAKE showed good sensitivity to change; scores were 69.2 (15.3) then 82.7 (14.0) after patient education sessions (Hedges effect size = 0.92, 95% CI 0.52-1.31). CONCLUSION SPAKE is a knowledge questionnaire for patients with axSpA, developed with the involvement of HCPs and patients and reflecting current recommendations for the management of axSpA. SPAKE will be useful in assessing knowledge acquisition and self-management strategies in routine care and research.
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Affiliation(s)
- Catherine Beauvais
- C. Beauvais, MD, Service de Rhumatologie Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, AP-HP, Paris;
| | - Bruno Pereira
- B. Pereira, PhD, Département de Biostatistique Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Thao Pham
- T. Pham, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Sainte Marguerite, Université Aix Marseille, Marseille
| | - Christelle Sordet
- C. Sordet, MD, PhD, Service de Rhumatologie, Hôpitaux Universitaires Strasbourg, Strasbourg
| | - Pascal Claudepierre
- P. Claudepierre, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Henri Mondor, AP-HP, Université Créteil, Paris
| | - Françoise Fayet
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Daniel Wendling
- D. Wendling, MD, PhD, Service de Rhumatologie, Centre Hospitalier Régional Universitaire de Besançon, and EA 4266 EPILAB, Université Bourgogne Franche-Comté, Besançon
| | - Félicie Costantino
- F. Costantino, MD, PhD, Service de Rhumatologie, Hôpital Universitaire Ambroise Paré, AP-HP, Université Paris Saclay, Boulogne-Billancourt
| | - Laurence Carton
- L. Carton, Association AFLAR (Association Française de Lutte Anti-Rhumatismale), Paris
| | - Laurent Grange
- L. Grange, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire Grenoble Alpes, Echirolles
| | - Martin Soubrier
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
| | - Nathalie Legoupil
- N. Legoupil, MD, Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, AP-HP, Paris
| | - Aleth Perdriger
- A. Perdriger, MD, PhD, Service de Rhumatologie, Centre Hospitalier Universitaire, Rennes
| | - Isabel Tavares
- I. Tavares, Service de Rééducation, Hôpital Universitaire Montpellier, Montpellier
| | - Emmanuelle Dernis
- E. Dernis, MD, MSc, Service de Rhumatologie, Hôpital Le Mans, Le Mans
| | - Laure Gossec
- L. Gossec, Sorbonne Université, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, and Service de Rhumatologie, Centre Hospitalier Universitaire Pitié Salpétrière, Sorbonne Université AP-HP, Paris France
| | - Malory Rodère
- F. Fayet, BSc, M. Soubrier, MD, PhD, M. Rodère, BSc, Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel-Montpied, Clermont-Ferrand
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3
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Beauvais C, Pham T, Montagu G, Gleizes S, Madrisotti F, Lafourcade A, Vidal C, Dervin G, Baudard P, Desouches S, Tubach F, Le Calvez J, de Quatrebarbes M, Lafarge D, Grange L, Alliot-Launois F, Jeantet H, Antignac M, Tropé S, Besset L, Sellam J. Development and real-life use assessment of a self-management smartphone application for patients with inflammatory arthritis. A user-centred step-by-step approach. PLoS One 2022; 17:e0272235. [PMID: 36107954 PMCID: PMC9477307 DOI: 10.1371/journal.pone.0272235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 07/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Mobile health applications (apps) are increasing in interest to enhance patient self-management. Few apps are actually used by patients and have been developed for patients with inflammatory arthritis (IA) treated with disease-modifying anti-rheumatic drugs which use entails risk of adverse effects such as infections. Objective To develop Hiboot, a self-management mobile app for patients with IA, by using a user-centred step-by-step approach and assess its real-life use. Methods The app development included first a qualitative study with semi-guided audiotaped interviews of 21 patients to identify the impact of IA on daily life and patient treatments practices and an online cross-sectional survey of 344 patients to assess their health apps use in general and potential user needs. A multidisciplinary team developed the first version of the app via five face-to-face meetings. After app launch, a second qualitative study of 21 patients and a users’ test of 13 patients and 3 rheumatologists led to the app’s current version. The number of app installations, current users and comments were collected from the Google Play store and the Apple store. Results The qualitative study revealed needs for counselling, patient–health professional partnership, and skills to cope with risk situations; 86.8% participants would be ready to use an app primarily on their rheumatologist’s recommendation. Six functionalities were implemented: a safety checklist before treatment administration, aids in daily life situations based on the French academic recommendations, treatment reminders, global well-being self-assessment, periodic counselling messages, and a diary. The Hiboot app was installed 20,500 times from September 2017 to October 2020, with 4300 regular current users. Scores were 4.4/5 stars at Android and iOS stores. Conclusion Hiboot is a free self-management app for patients with IA developed by a step-by-step process including patients and health professionals. Further evaluation of the Hiboot benefit is needed.
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Affiliation(s)
- Catherine Beauvais
- Service de Rhumatologie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
- * E-mail:
| | - Thao Pham
- Service de Rhumatologie, Hôpital Sainte Marguerite, Aix Marseille Univ, Assistance Publique Hôpitaux de Paris (APHM), Marseille, France
| | - Guillaume Montagu
- Département de Recherche, Unknowns, Conseil en Stratégie et Innovation, Paris, France
| | - Sophie Gleizes
- Département de Recherche, Unknowns, Conseil en Stratégie et Innovation, Paris, France
- Laboratoire d’Anthropologie Sociale (LAS), Collège de France/EHESS/EPHE, Paris, France
| | - Francesco Madrisotti
- Département de Recherche, Unknowns, Conseil en Stratégie et Innovation, Paris, France
- Centre de National de la Recherche Scientifique (CNRS), Laboratoire CERMES3 (CNRS-EHESS-INSERM), Université de Paris, Paris, France
| | - Alexandre Lafourcade
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
- Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1422, Hôpital Pitié Salpêtrière, Sorbonne Université, APHP, Paris, France
| | | | - Guillaume Dervin
- Clinique Juge, Institut Médical Sport Santé Marseille, Marseille, France
| | - Pauline Baudard
- Service de Rhumatologie, Centre Hospitalo-Universitaire Caen, Caen, France
| | - Sandra Desouches
- Service de Rhumatologie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
| | - Florence Tubach
- Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, INSERM, Paris, France
- Département de Santé Publique, Centre de Pharmacoépidémiologie (Cephepi), CIC-1422, Hôpital Pitié Salpêtrière, Sorbonne Université, APHP, Paris, France
| | | | | | | | - Laurent Grange
- AFLAR Association Française de Lutte Anti rhumatismale (AFLAR), Paris, France
| | | | - Henri Jeantet
- Unknowns, Conseil en Stratégie et Innovation, Paris, France
| | - Marie Antignac
- Service de Pharmacie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
- Equipe d’Épidémiologie Intégrative, INSERM U 970, PARCC, Paris, France
| | - Sonia Tropé
- Association Nationale de Défense Contre l’Arthrite Rhumatoïde (ANDAR), Paris, France
| | - Ludovic Besset
- Unknowns, Conseil en Stratégie et Innovation, Paris, France
| | - Jérémie Sellam
- Service de Rhumatologie, Hôpital Saint Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, Paris, France
- Centre de Recherche Saint-Antoine (CRSA), INSERM UMRS_938, FHU PaCeMM, Paris, France
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Beauvais C. Pourquoi croyons-nous aux fake news? Revue du Rhumatisme 2022; 89:555-561. [PMID: 36267475 PMCID: PMC9558089 DOI: 10.1016/j.rhum.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Accepted: 02/22/2022] [Indexed: 12/02/2022]
Abstract
Ces dernières années, les fake news ont connu une propagation exponentielle, en particulier depuis l’élection américaine de Donald Trump et la pandémie de la COVID-19. La recherche s’est intéressée à la création, à l’utilisation, au partage et à l’identification des fake news et cherche à mettre en œuvre des moyens visant à enrayer le flux de fausses informations et empêcher que l’on y croie. Cette mise à jour aborde une partie seulement de la problématique des fake news et met l’accent sur les déterminants qui favorisent la croyance aux fausses nouvelles ; à noter que la rhumatologie est peu représentée. Certains facteurs sont directement liés à l’écosystème des médias et des réseaux sociaux comme la disponibilité et la propagation rapide des fake news, la non-sélection des informations relayées sur ces plateformes et le fait que les individus peuvent être à la fois consommateurs et créateurs de fake news. Les facteurs cognitifs occupent une place importante comme le biais de confirmation, l’appartenance politique, l’exposition répétée aux fausses nouvelles et le raisonnement intuitif. L’absence de connaissances scientifiques et un faible niveau d’études contribuent également à croire aux fake news. Les facteurs psychologiques regroupent l’attrait de la nouveauté, l’état émotionnel des individus et le contenu émotionnel des fake news. Un niveau élevé de littéracie numérique réduit la vulnérabilité aux fake news. Des facteurs sociologiques, tels que les communautés en ligne (ou chambres d’écho) et le rôle des groupes de pression, ont été identifiés. Des implications pratiques peuvent être déduites pour limiter les fake news : l’éducation aux médias et l’utilisation de mises en garde contre les fake news, le journalisme fondé sur des données probantes et la vérification des faits, la régulation des réseaux sociaux, la collaboration des plateformes médiatiques avec des organismes de fact-checking, les messages d’alerte sur les réseaux et les solutions de détection digitale. Les professionnels de santé doivent mieux comprendre les facteurs qui alimentent la croyance aux fake news. L’identification de ces déterminants pourrait ainsi faciliter leur rôle de conseil auprès des patients concernant le phénomène de désinformation.
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5
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Bennett SE, Zangi HA, Larsson I, Beauvais C, Boström C, Domján A, van Eijk-Hustings Y, Van der Elst K, Fayet F, Ferreira RJO, Fusama M, Geneva-Popova M, Herrero Manso MDC, Hoeper K, Jones B, Kukkurainen ML, Gladys Kwok SK, Minnock P, Nava T, Primdahl J, Rawat R, Sierakowska M, Stoffer-Marx M, van Tubergen A, Ndosi M. Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries. Ann Rheum Dis 2022; 81:1348-1357. [PMID: 35676076 DOI: 10.1136/annrheumdis-2022-222253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 05/19/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. METHODS A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. RESULTS A total of 1159 completed the survey; 852 (73.5%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery. CONCLUSIONS This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools.
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Affiliation(s)
- Sarah E Bennett
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK.,Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Heidi A Zangi
- National Advisory Unit for Rehabilitation in Rheumatology, Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.,Faculty of Health, VID Specialized University, Oslo, Norway
| | - Ingrid Larsson
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden.,Spenshult Research and Development Centre, Halmstad, Sweden
| | - Catherine Beauvais
- Rheumatology Department, Hôpital Saint-Antoine Sorbonne Université Assistance Publique Hôpitaux de Paris, Paris, France
| | - Carina Boström
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Andrea Domján
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hajdú-Bihar, Hungary
| | - Yvonne van Eijk-Hustings
- Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands
| | - Kristien Van der Elst
- Department of Rheumatology, University Hospitals Leuven, KU Leuven University Hospitals Leuven, Leuven, Flanders, Belgium
| | - Françoise Fayet
- Department of Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Ricardo J O Ferreira
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon (ESEL), Lisbon, Portugal.,Rheumatology department, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Mie Fusama
- School of Nursing, Takarazuka University, Osaka, Japan
| | | | | | - Kirsten Hoeper
- Rheumatology and Immunology, Medizinische Hochschule Hannover Klinikum, Hannover, Germany
| | - Bethan Jones
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK
| | | | - Suet Kei Gladys Kwok
- Rheumatology and Clinical Immunology Unit, Grantham Hospital, Hong Kong, Hong Kong
| | - Patricia Minnock
- Rheumatic Musculoskeletal Disease Unit, Our Lady's Hospice & Care Services, Dublin, Ireland
| | - Tiziana Nava
- Department of Translational Medicine and Surgery, University of Milan-Bicocca, Milano, Lombardia, Italy
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Odense, Syddanmark, Denmark.,Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sønderborg, Denmark
| | - Roopa Rawat
- Indian Spinal Injuries Centre, New Delhi, India
| | - Matylda Sierakowska
- Department of Integrated Medical Care, Medical University of Bialystok, Bialystok, Poland
| | - Michaela Stoffer-Marx
- Institute for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Wien, Austria.,Department of Health Sciences, FH Campus Wien, University of Applied Sciences, , Vienna, Austria
| | - Astrid van Tubergen
- Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, Netherlands.,Department of Rheumatology, Maastricht University Medical Centre+, Maastricht, Limburg, The Netherlands
| | - Mwidimi Ndosi
- School of Health and Social Wellbeing, University of the West of England, Bristol, UK .,Academic Rheumatology, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
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6
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Rodère M, Pereira B, Soubrier M, Fayet F, Piperno M, Pallot-Prades B, Pouplin S, Baudens G, Cohen JD, Coquerelle P, Grange L, Sordet C, Tropé S, Gossec L, Beauvais C. Development and validation of a self-administered questionnaire measuring essential knowledge in patients with rheumatoid arthritis. Rheumatol Int 2022; 42:1785-1795. [PMID: 35389078 PMCID: PMC9439984 DOI: 10.1007/s00296-022-05090-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/01/2022] [Indexed: 11/26/2022]
Abstract
To develop and validate a questionnaire assessing patient knowledge in rheumatoid arthritis (RA). Knowledge considered essential for patients with RA was identified through a series of Delphi rounds among rheumatologists, health professionals (HPs), patients, and then reformulated to construct the knowledge questionnaire. Cross-sectional multicenter validation was performed in 12 rheumatology departments to assess internal validity (Kuder–Richardson coefficient), external validity, acceptability, reproducibility (Lin’s concordance correlation coefficient) and sensitivity to change (difference in total score before and after patient education sessions). Associations between patient variables and knowledge levels were evaluated. RAKE (RA Knowledge questionnairE) is a self-administered 45-item questionnaire scored 0–100, with a 32-item short-form survey assessing knowledge of disease, comorbidity, pharmacological treatments, non-pharmacological treatments, self-care and adaptative skills. Of 130 patients included in the validation study, 108 were women. Acceptability was good with < 5% missing data. Internal validity coefficient was 0.90. Mean (standard deviation) long-form score was 72.8 ± 17.8, with lower scores in comorbidity and self-care and higher scores in adaptive skills. Reproducibility was good (0.86 [0.80; 0.92]). RAKE score was positively correlated with the patients’ level of education and the HPs’ opinion on the patients’ knowledge. RAKE score showed good sensitivity to change: 66.8 ± 16.4 then 83.8 ± 12.7, representing a hedges effect size of 1.14 [95% CI 0.73; 1.55]. RAKE is an updated questionnaire assessing essential knowledge for patients with RA to enhance self-management according to current guidelines and the patients’ perspective. RAKE can usefully inform patient education interventions, routine care and research.
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Affiliation(s)
- Malory Rodère
- Rheumatology Department, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France.
| | - Bruno Pereira
- Biostatistics Unit, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Martin Soubrier
- Rheumatology Department, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Françoise Fayet
- Rheumatology Department, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Muriel Piperno
- Rheumatology Department, Centre Hospitalier Universitaire Lyon-Sud, Lyon, France
| | - Béatrice Pallot-Prades
- Rheumatology Department, Centre Hospitalier Universitaire de Saint Etienne, Fondation partage et vie, Centre médical de l'Argentière, Hôpital Bellevue, Saint Etienne, France
| | - Sophie Pouplin
- Rheumatology Department, Hôpital Universitaire de Rouen, Rouen, France
| | | | - Jean-David Cohen
- Rheumatology Department, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | | | - Laurent Grange
- Rheumatology Department, Centre Hospitalier Universitaire Grenoble Alpes, Echirolles, France
| | - Christelle Sordet
- Rheumatology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sonia Tropé
- Association Nationale de Défense contre l'Arthrite Rhumatoïde, Paris, France
| | - Laure Gossec
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France.,Rheumatology, Pitié Salpêtrière Hospital, APHP, Sorbonne Université, Paris, France
| | - Catherine Beauvais
- Rheumatology Department, Sorbonne Université, Centre Hospitalier Universitaire Saint Antoine, Assistance Publique Hôpitaux de Paris, APHP, Paris, France
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7
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Beauvais C, Fayet F, Rousseau A, Sordet C, Pouplin S, Maugars Y, Poilverd RM, Savel C, Ségard V, Godon B, L'amour C, Perdriger A, Brin F, Peyrard P, Chalier F, Pallot-Prades B, Tuffet S, Griffoul I, Gossec L. Efficacy of a nurse-led patient education intervention in promoting safety skills of patients with inflammatory arthritis treated with biologics: a multicentre randomised clinical trial. RMD Open 2022; 8:rmdopen-2021-001828. [PMID: 35296528 PMCID: PMC8928395 DOI: 10.1136/rmdopen-2021-001828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022] Open
Abstract
Objective To evaluate the effect of a nurse-led patient education on safety skills of patients with inflammatory arthritis treated with biologic disease-modifying antirheumatic drugs (bDMARDs). Methods This is a multicentre, open-labelled, randomised controlled trial comparing an intervention group (face-to-face education by a nurse at baseline and 3 months later) with a control group (usual care) at the introduction of a first subcutaneous bDMARD. The primary outcome was score on the BioSecure questionnaire at 6 months (0–100 scale), a validated questionnaire assessing competencies in dealing with fever, infections, vaccination and daily situations. The secondary outcomes were disease activity, coping, psychological well-being, beliefs about medication, self-efficacy and severe infection rate. Results 129 patients with rheumatoid arthritis and spondyloarthritis were enrolled in nine rheumatology departments; 122 completed the study; 127 were analysed; and 64 received the intervention (mean duration: 65 min at baseline and 44 min at 3 months). The primary outcome was met: the BioSecure score was 81.2±13.1 and 75.6±13.0 in the education and usual care groups (difference: +6.2, 95% CI 1.3 to 11.1, p=0.015), demonstrating higher safety skills in the education group. Exploratory analyses showed better skills regarding infections, greater willingness for vaccinations and greater adherence-related behaviours in the education group. Coping was significantly more improved by education; other secondary outcomes were improved in both groups, with no difference. Conclusions Educating patients was effective in promoting patient behaviours for preventing adverse events with bDMARDs. An education session delivered to patients starting a first bDMARD can be useful to help them self-manage safety issues. Trial registration number NCT02855320.
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Affiliation(s)
- Catherine Beauvais
- Rheumatology Department, Centre Hospitalier Universitaire Saint Antoine,Sorbonne Université, APHP, Paris, France
| | - Françoise Fayet
- Rheumatology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Alexandra Rousseau
- Service de Pharmacologie Clinique et Plateforme de Recherche Clinique de l'Est Parisien, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, APHP, Paris, France
| | - Christelle Sordet
- Rheumatology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sophie Pouplin
- Service de Rhumatologie, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Yves Maugars
- Rheumatology, Centre Hospitalier Universitaire de Nantes Hôpital Saint Jacques, Nantes, France.,Medical Faculty, Universite de Nantes Pole Sante, Nantes, France
| | - Rose Marie Poilverd
- Rheumatology Department, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, APHP, Paris, France
| | - Carine Savel
- Rheumatology, Centre Hospitalier Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Véronique Ségard
- Rheumatology Department, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Béatrice Godon
- Rheumatology Department, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - Christian L'amour
- Rheumatology Department, Centre Hospitalier Universitaire Pitié Salpétrière, Sorbonne Université, APHP, Paris, France
| | - Aleth Perdriger
- Rhumatologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Fabienne Brin
- Rheumatology Department, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Patricia Peyrard
- Rheumatology Department, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Fabienne Chalier
- Rheumatology Department, Centre Hospitalier Régional Universitaire de Tours, Tours, France
| | - Béatrice Pallot-Prades
- Rheumatology Department, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Etienne, France
| | - Sophie Tuffet
- Rheumatology Department, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, APHP, Paris, France
| | - Isabelle Griffoul
- Rheumatology, Centre Hospitalier Regional Universitaire de Tours, Tours, France
| | - Laure Gossec
- INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France.,APHP, Rheumatology Department, Hopital Universitaire Pitie Salpetriere, Paris, France
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Abstract
Fake news dissemination has increased greatly in recent years, with peaks during the US presidential elections and the COVID-19 pandemic. Research has addressed fake news creation, consumption, sharing, and detection as well as approaches to counteract it and prevent people from believing it. This update addresses only a part of the fake news-related issues and focuses on determinants leading individuals to believe fake news, noting that rheumatology is scarcely represented. Some determinants relate to the ecosystem of media and social networks, such as the availability and rapid spread of fake news, the unselected information on platforms and the fact that consumers can become creators of fake news. Cognitive factors are important, such as confirmation bias, political partisanship, prior exposure and intuitive thinking. Low science knowledge and low educational level are also involved. Psychological factors include attraction to novelty, high emotional state, and the emotionally evocative content of fake news. High digital literacy protects against believing fake news. Sociological factors such as online communities, or echo chambers, and the role of pressure groups have been identified. The implication for practice can be deduced, including education in media literacy and warning tips, reliable journalism and fact-checking, social media regulation, partnership of media platforms’ with fact-checkers, warning messages on networks, and digital detection solutions. Health professionals need to better understand the factors that cause individuals to believe fake news. Identifying these determinants may help them in their counseling role when talking to patients about misinformation.
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Petit J, Antignac M, Poilverd RM, Baratto R, Darthout S, Desouches S, Louati K, Deparis N, Berenbaum F, Beauvais C. Multidisciplinary team intervention to reduce the nocebo effect when switching from the originator infliximab to a biosimilar. RMD Open 2021; 7:rmdopen-2020-001396. [PMID: 33495387 PMCID: PMC7839879 DOI: 10.1136/rmdopen-2020-001396] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/25/2020] [Accepted: 11/04/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives To evaluate an intervention to reduce the nocebo effect (NE) when switching from the originator infliximab (OI) to the infliximab biosimilar SB2 in chronic inflammatory rheumatic disease (CIRD). Methods An intervention was built with healthcare professionals (HPs) and a patient representative, based on a systematic review of interventions reducing the NE in musculoskeletal diseases and semi-directed questioning of five patients. Our strategy consisted of training HPs, switch information given by the nurses, a consistent vocabulary. All CIRD patients switched from OI to SB2 were included for the intervention. The primary outcome was the SB2 retention rate (RR) at 34 weeks. Secondary outcomes were the SB2 RR at 12 months, discontinuation rates due to a possible NE and comparison with a historical cohort of CIRD patients receiving the OI and 6 published European cohorts. Results 45 patients were included from March 2018 (rheumatoid arthritis, n=17, spondylarthritis, n=28). After 34 weeks, the SB2 RR was 91.2%, similar to the historical cohort RR (p=0.41) but higher than the 3 European cohort RRs (p<0.05). At 12 months, the SB2 RR was 84.5% vs 88.4% for the historical cohort (p=0.52). SB2 discontinuation due to a possible NE was 6.6% after 12 months. Conclusions A tailored communication with a prominent role of nurses reduced the NE in non-medical switches from the OI to SB2 as compared to published results. The RR was similar to the historical cohort RR. The methodology used to construct this intervention may help improve the outcomes of switches with upcoming biosimilars.
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Affiliation(s)
- Juliette Petit
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
| | | | | | - Régine Baratto
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
| | - Sylvie Darthout
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
| | - Sandra Desouches
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
| | - Karine Louati
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
| | - Nathalie Deparis
- Association ANDAR (Association Nationale de Défense Contre l'Arthrite Rhumatoïde), Paris, France
| | - Francis Berenbaum
- Rheumatology, Hopital Saint-Antoine, Sorbonne University, Paris, France
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10
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Sabouret P, Attias D, Beauvais C, Berthelot E, Bouleti C, Gibault Genty G, Galat A, Hanon O, Hulot JS, Isnard R, Jourdain P, Lamblin N, Lebreton G, Lellouche N, Logeart D, Meune C, Pezel T, Damy T. Diagnosis and management of heart failure from hospital admission to discharge: A practical expert guidance. Ann Cardiol Angeiol (Paris) 2021; 71:41-52. [PMID: 34274113 DOI: 10.1016/j.ancard.2021.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/07/2021] [Indexed: 10/20/2022]
Abstract
Heart failure (HF) has high event rates, mortality, and is challenging to manage in clinical practice. Clinical management is complicated by complex therapeutic strategies in a population with a high prevalence of comorbidity and general frailty. In the last four years, an abundance of research has become available to support multidisciplinary management of heart failure from within the hospital through to discharge and primary care as well as supporting diagnosis and comorbidity management. Within the hospital setting, recent evidence supports sacubitril-valsartan combination in frail, deteriorating or de novo patients with LVEF≤40%. Furthermore, new strategies such as SGLT2 inhibitors and vericiguat provide further benefit for patients with decompensating HF. Studies with tafamidis report major clinical benefits specifically for patients with ATTR cardiac amyloidosis, a remaining underdiagnosed and undertreated disease. New evidence for medical interventions supports his bundle pacing to reduce QRS width and improve haemodynamics as well as ICD defibrillation for non-ischemic cardiomyopathy. The Mitraclip reduces hospitalisations and mortality in patients with symptomatic, secondary mitral regurgitation and ablation reduces mortality and hospitalisations in patients with paroxysmal and persistent atrial fibrillation. In end-stage HF, the 2018 French Heart Allocation policy should improve access to heart transplants for stable, ambulatory patients and, mechanical circulatory support should be considered to avoid deteriorating on the waiting list. In the community, new evidence supports that improving discharge education, treatment and patient support improves outcomes. The authors believe that this review fills the gap between the guidelines and clinical practice and provides practical recommendations to improve HF management.
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Affiliation(s)
- P Sabouret
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - D Attias
- Cardiology department, Centre Cardiologique du Nord, Saint-Denis, France
| | - C Beauvais
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - E Berthelot
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - C Bouleti
- Cardiology department, Poitiers University Hospital, CIC INSERM 1402, Poitiers, France
| | - G Gibault Genty
- Cardiology department, André Mignot Hospital, Le Chesnay, France
| | - A Galat
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - O Hanon
- Geriatrics Department, Hospital Broca, Paris Descartes University, Paris, France
| | - J S Hulot
- Pharmacology Department, Georges-Pompidou European Hospital, INSERM, PARCC, CIC1418 Paris-Descartes University, Paris, France
| | - R Isnard
- Heart Institute, Cardiology department, La Pitié Salpetrière Hospital, Sorbonne University, Paris, France
| | - P Jourdain
- Cardiology department, Kremlin Bicêtre Hospital, Paris-Saclay University, Le Kremlin Bicêtre, France
| | - N Lamblin
- Cardiology Department, University Hospital, Lille, France
| | - G Lebreton
- Heart Institute, Cardiac Surgery department, La Pitié Salpêtrière Hospital, Sorbonne University, Paris, France
| | - N Lellouche
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France
| | - D Logeart
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - C Meune
- Department of Cardiology, Avicenne Hospital, Paris 13 University, Bobigny, France
| | - T Pezel
- Cardiology department, La Riboisière Hospital, Inserm UMRS 942, University of Paris, Paris, France
| | - T Damy
- Cardiology department, University Hospital Henri Mondor, UPEC, Créteil, France.
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11
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Beauvais C, Gaud-Listrat V, Sellam J, Fayet F, Beranger M, Deparis N, Antignac M, Sordet C, Rodere M, Gossec L. POS1450 PATIENTS’ SAFETY SKILLS ASSESSMENT WITH BIOLOGICS AND JAK INHIBITORS: UPDATE OF THE BIOSECURE QUESTIONNAIRE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Biologic disease-modifying anti-rheumatic drug (bDMARDs) and JAK inhibitors (JAKi) may lead to an increased risk of infections, which could be prevented by enhancing patients’ safety skills (ref). We developed a self-administered questionnaire (BioSecure1, ref) in 2013 to assess the patients’ safety skills (Table 1). Following the appearance of new bDMARDs and JAKi and new information on safety, this questionnaire needed updating.Table 1.Nine domains of core safety skills and number of corresponding questions in BioSecure questionnaires.Domain of competenceBioSecure1BioSecure2General knowledge42Dealing with infectious symptoms and fever1011Dealing with other infectious symptoms44Dealing with injuries, preventing infectious complications, vaccinations88Dental hygiene, preventing infectious complications, information to share with the dentist22Planning surgery, information to share with the surgeon/anesthesiologist77Planning child conception21Communication: who to contact?22Subcutaneous treatments: cold chain/cold storage, subcutaneous injection techniques30Objectives:To update the BioSecure questionnaire assessing patients’ safety skillsMethods:Four steps by a 10 participants multidisciplinary steering committee. Step1: critical analysis of content and formulations of BioSecure1 on the basis of i) the participants’ own experience of the questionnaire use in current practice (5/10 participants) or research (6/10 participants) ii) assessment of BioSecure1 consistency with current guidelines for management of targeted drugs. Step2: development of a first updated version by a core group of 10 persons. Step3: comments by an extended panel of rheumatology teams interested in therapeutic patient education (TPE). Step4: testing of the final version (Biosecure2) by ten patients through cognitive debriefing.Results:In total, 10 rheumatologists, 6 rheumatology nurses, 1 pharmacist and 1 patient from a patient association participated. Inadequate formulations were reported regarding some situations for which recommendations had the most shifted since Biosecure1 development such as planning pregnancy, remission management and prevention measures before surgery. Features of some infectious conditions were clarified; barriers measures against infection and complications such as sigmoiditis and Herpes Zoster infection were added. BioSecure2 continues to assess the 9 domains of core safety skills (Table 1). The questionnaire was shortened to 50 items (mean filling in time is 10 minutes) with a good understanding and scoring was simplified (mean scoring time 3.5 minutes).Conclusion:BioSecure2 represents an updated outcome measure to evaluate the patient’s skills to prevent adverse events with targeted therapies. This questionnaire can be useful in the context of patient-health professional communication, and as a tool to measure TPE on safety issues.References:[1]Gossec et al, Joint Bone Spine. 2013;80:471–476Disclosure of Interests:None declared
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12
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Beauvais C, Gaud-Listrat V, Sellam J, Fayet F, Béranger M, Deparis N, Antignac M, Sordet C, Rodère M, Gossec L. Patients' safety skills assessment with biologics and JAK inhibitors: Update of the BioSecure questionnaire. Joint Bone Spine 2021; 88:105215. [PMID: 33992790 DOI: 10.1016/j.jbspin.2021.105215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/27/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Catherine Beauvais
- Service de Rhumatologie, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
| | - Véronique Gaud-Listrat
- Service de Rhumatologie, Centre Hospitalier Universitaire Cochin, AP-HP, Paris, France; RHEVER* network, (*"Hospital And City In Rheumatology Network"), Paris, France
| | - Jérémie Sellam
- Service de Rhumatologie, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France; Sorbonne Université, Centre de Recherche Saint-Antoine (CRSA), INSERM UMRS_938, Paris, France
| | - Françoise Fayet
- Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Martine Béranger
- Service de Rhumatologie, Centre Hospitalier Universitaire Orléans, Orléans, France
| | - Nathalie Deparis
- ANDAR Association Nationale de Défense contre l'Arthrite Rhumatoïde (ANDAR), Paris, France
| | - Marie Antignac
- Pharmacie, Centre Hospitalier Universitaire Saint Antoine, Sorbonne Université, AP-HP, Paris, France
| | - Christelle Sordet
- Service de Rhumatologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Malory Rodère
- Service de Rhumatologie, Centre Hospitalier Universitaire Gabriel Montpied, Clermont-Ferrand, France
| | - Laure Gossec
- Service de Rhumatologie, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France; Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France
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13
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Rat AC, Brignon M, Beauvais C, Beranger M, Boujut E, Cohen JD, Delannoy C, Griffoul-Espitalier I, Kivits J, Poivret D, Thevenot C, Trope S, Untas A, Vioulac C, Alleyrat C, Giraudet-Le Quintrec JS. Patients and spouses coping with inflammatory arthritis: Impact of communication and spousal perceived social support and burden. Joint Bone Spine 2021; 88:105125. [DOI: 10.1016/j.jbspin.2020.105125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Accepted: 11/30/2020] [Indexed: 10/22/2022]
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14
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Molto A, Gossec L, Poiraudeau S, Claudepierre P, Soubrier M, Fayet F, Wendling D, Gaudin P, Dernis E, Guis S, Pouplin S, Ruyssen-Witrand A, Chales G, Mariette X, Beauvais C, Combe B, Flipo RM, Richette P, Chary-Valckenaere I, Saraux A, Sibilia J, Schaeverbeke T, Dougados M. Evaluation of the impact of a nurse-led program of patient self-assessment and self-management in axial spondyloarthritis: results of a prospective, multicentre, randomized, controlled trial (COMEDSPA). Rheumatology (Oxford) 2021; 60:888-895. [PMID: 33063096 DOI: 10.1093/rheumatology/keaa480] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/14/2020] [Indexed: 01/20/2023] Open
Abstract
OBJECTIVE To evaluate the impact of a nurse-led program of self-management and self-assessment of disease activity in axial spondyloarthritis. METHODS Prospective, randomized, controlled, open, 12-month trial (NCT02374749). Participants were consecutive axial spondyloarthritis patients (according to the rheumatologist) and nurses having participated in a 1-day training meeting. The program included self-management: educational video and specific video of graduated, home-based exercises for patients; and self-assessment: video presenting the rationale of tight monitoring of disease activity with composite scores (Ankylosing Spondylitis Disease activity Score, ASDAS/Bath Ankyslosing Spondylitis Disease Activity Index, BASDAI). The nurse trained patients to collect, calculate and report (monthly) ASDAS/BASDAI. Treatment allocation was by random allocation to this program or a comorbidities assessment (not presented here and considered here as the control group). RESULTS A total of 502 patients (250 and 252 in the active and control groups, respectively) were enrolled (age: 46.7 (12.2) years, male gender: 62.7%, disease duration: 13.7 (11.0) years). After the one-year follow-up period, the adherence to the self-assessment program was considered good (i.e. 79% reported scores >6 times). Despite a lack of statistical significance in the primary outcome (e.g. coping) there was a statistically significant difference in favor of this program for the following variables: change in BASDAI, number and duration of the home exercises in the active group, and physical activity (international physical activity score, IPAQ). CONCLUSION This study suggests a short-term benefit of a nurse-led program on self-management and self-assessment for disease activity in a young axial spondyloarthritis population in terms of disease activity, exercises and physical activity.
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Affiliation(s)
- Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France.,Université de Paris, INSERM U-1153, CRESS, France
| | - Laure Gossec
- Sorbonne Université, IPLESP, INSERM, France.,Pitié Salpêtrière Hospital, APHP, Rheumatology Department, France
| | - Serge Poiraudeau
- Rehabilitation and Physical Medicine Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pascal Claudepierre
- Rheumatology Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, and Université Paris Est Créteil, EA, 7379 - EpidermE, Créteil, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Françoise Fayet
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Daniel Wendling
- Rheumatology Department, CHRU de BESANCON, University Teaching Hospital, and Université Bourgogne Franche-Comté, EA4266 (EPILAB), Besançon, France
| | | | | | | | | | - Adeline Ruyssen-Witrand
- Centre de Rhumatologie, Hôpital Purpan, et Faculté de Médecine, Université Toulouse III, Paul Sabatier University, Inserm UMR1027, Toulouse, France
| | - Gerard Chales
- Medecine Faculty, Department of Rheumatology, South Hospital, Rennes 1 University, Rennes, France
| | - Xavier Mariette
- Rheumatology Department, APHP, Bicêtre Hospital, Le Kremlin-Bicetre, France
| | | | - Bernard Combe
- Rheumatology Department, CHU Montpellier, Montpellier University, Montpellier, France
| | - René-Marc Flipo
- Rheumatology Department, CHU Roger Salengro Hospital, University of Lille, Lille, France
| | - Pascal Richette
- Université Paris Diderot, UFR médicale, France.,APHP Hôpital Lariboisiére, Fédération de Rhumatologie, Paris, France
| | | | - Alain Saraux
- Rheumatology Unit, UMR1227 (Lymphocytes B et Autoimmunité), Université de Brest, Inserm, CHU, Brest, LabEx IGO, Brest, France
| | - Jean Sibilia
- Department of Rheumatology, Hautepierre CHU, Fédération de médecine translationnelle, UMR INSERM 1109, Strasbourg, France
| | | | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, France.,Université de Paris, INSERM U-1153, CRESS, France
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Petit J, Antignac M, Louati K, Desouches S, Deparis N, Baratto R, Poilverd R, Dartout S, Berenbaum F, Beauvais C. FRI0630-HPR ONE-YEAR FOLLOW-UP OF A NURSE-LED TEAM INTERVENTION EFFECTIVE IN REDUCING THE NOCEBO EFFECT WHEN SWITCHING FROM ORIGINATOR INFLIXIMAB TO A BIOSIMILAR. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Nonspecific subjective adverse effects and symptoms (NSAE/NSS), usually considered as related to a nocebo effect (NE), have been identified as a barrier to the acceptability of switches from biologic originators (BO) to biosimilars (BS) in rheumatology. A multidisciplinary team intervention with a prominent role of nurses has provided a reduction of the NE assessed in the short-term during a systematic switch from originator Infliximab (OI) to the biosimilar infliximab SB2 (ref.1).Objectives:To assess the intervention outcomes after one-year follow up in comparison with a historical cohort.Methods:The intervention was developed after a literature search and semi-directive interviews of patients, and included consensual communication towards patients, with a prominent role of nurses (Ref.1). All patients with chronic inflammatory rheumatic diseases (CIRD) treated by OI were included and followed-up in routine care. The outcomes were I) SB2 retention rate (RR) II) SB2 discontinuation rate due to a presumed NE, defined as lack of efficacy with no objective criteria for increased inflammation or non-objective and non-specific adverse event, either occurring after the switch and disappearing after back-switch or change of biologic. Criteria for NSAE/NSS in the historical cohort were the same lack of efficacy or subjective adverse events and disappearance after change of biologic BD. Medium-term (12 months) SB2 outcomes were assessed and compared with I) the data obtained in the short-term (34 weeks) II) the data from an historical cohort of CIRD patients treated by OI in the same rheumatology department, using Kaplan-Meier survival curve.Results:Forty-five patients were prospectively included for the switch from March 2018 to August 2018: 17 with rheumatoid arthritis (RA), 28 with spondylarthritis (SpA); 55% were women, mean age was 53.2 (SD: 2,1), and mean time under OI was 113.5 (SD9.3). For the historical cohort, the 52 patients treated with OI between December 2016 and January 2017 were included and their data collected at baseline and one year. Fifty-nine percent were women, mean age at inclusion was 50.25 (1.2), and mean time under OI was 94.8 (9.4).SB2 RR did not differ from the OI RR in the historical cohort: 91.2% and 96.2% respectively at 34 weeks (p = 0.41); 84.4% and 88.5% respectively at 12 months (p = 0.52) (figure 1). The SB2 RR was significantly higher than in three other European cohorts at 34 weeks (mean RR 73.6%, p<0.05, ref.1) but not at 12 months (mean RR 80.9%, ref.2,3,4).SB2 and OI discontinuations due to NSAE/NSS at 34 weeks were 2,2 % and 1.9% respectively; at 12 months 6,6% and 1.9% respectively (p= 0.6).Conclusion:An intervention based on a tailored communication with a prominent role of nurses was effective in reducing the NE when switching from OI to SB2 in the short term, compared with an historical cohort and other European cohorts. The one-year follow-up showed no statistical difference in RR or NE compared with our historical cohort. The present study shows that appropriate interventions may be developed to improve the outcome of switches to biosimilars.Figure 1:Treatment withdrawal free survival curves (SB2 in switched cohort and OI in historical cohort).Kaplan Meir survival curves. Comparison with Log-Rank test between OI to SB2 cohort and historical OI cohort, p = 0.520. OI : original infliximab.References:[1] Petit J. Ann Rheum Dis, volume 78, supplement 2, year 2019, page A1447[2] Glintborg B. et al. Ann Rheum Dis 2017;76:1426–31.[3] Nikiphorou E. et al. Expert Opin Biol Ther 2015;15:1677–83.[4] Boone NW. et al. Eur J Clin Pharmacol 2018;:1–7.Acknowledgments:Dr Margaux Boisson Service de rhumatologie du Professeur Kahan, Hôpital Cochin, APHP.Disclosure of Interests:Juliette Petit: None declared, Marie Antignac: None declared, Karine Louati: None declared, Sandra Desouches: None declared, Nathalie DEPARIS: None declared, Regine Baratto: None declared, Rosemarie POILVERD: None declared, Sylvie Dartout: None declared, Francis Berenbaum Grant/research support from: TRB Chemedica (through institution), MSD (through institution), Pfizer (through institution), Consultant of: Novartis, MSD, Pfizer, Lilly, UCB, Abbvie, Roche, Servier, Sanofi-Aventis, Flexion Therapeutics, Expanscience, GSK, Biogen, Nordic, Sandoz, Regeneron, Gilead, Bone Therapeutics, Regulaxis, Peptinov, 4P Pharma, Paid instructor for: Sandoz, Speakers bureau: Novartis, MSD, Pfizer, Lilly, UCB, Abbvie, Roche, Servier, Sanofi-Aventis, Flexion Therapeutics, Expanscience, GSK, Biogen, Nordic, Sandoz, Regeneron, Gilead, Sandoz, Catherine Beauvais Speakers bureau: Abbvie, MSD, Roche, UCB, Mylan, Sanofi
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Montagu G, Gleizes S, Pham T, Sellam J, Beauvais C. THU0577 INFLUENCE OF THE ROUTE OF ADMINISTRATION ON SAFETY AND ADHERENCE PRACTICES OF RHEUMATOID PATIENTS TREATED BY JAK-INHIBITORS AND OTHER DMARDS. AN ETHNOGRAPHIC STUDY FOR AN APP-BASED EDUCATION TOOL. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:JAKi (JAK inhibitors) seem simpler of use than injected biologic agents due to their oral administration route. Safety and adherence issues remain and may need to modify patients’ counseling.Objectives:To understand the influence of the DMARDs’ route of administration on these issues for both patients and physicians in order to update the Hiboot®education tool (ref1).Methods:Hiboot®is a free smartphone application developed by the French Society of Rheumatology to enhance the patient’s safety, adherence to treatment, self-assessment and to give periodic counseling messages (ref1). This ethnographic study involved i)18 patients with rheumatoid arthritis (RA) recruited by 3 rheumatologists considering diversity of clinical and sociological profiles. The panel included i) 14 women and 4 men, median age 56 years-old, median disease duration 10 years. Four patients were treated by methotrexate (MTX) monotherapy, 5 with MTX-bDMARDs or MTX-JAKi combo, 1 by bDMARDs monotherapy, 8 by JAKi monotherapy; ii) 9 rheumatologists with hospital or mixed hospital-private practice from 6 cities in France.The interviews were conducted by 2 anthropologists using in-depth semi directive and biographical methods (enough to reach saturation), registered and transcribed. The semi-directive interviews dealt with: i) the patient history with RA and its treatments, ii) the daily medication management, iii) the evolution of patients’ perceptions and knowledge over time.Results:For patients, adherence and safety behaviors were guided by their representations of 3 risks: disease-related, treatment-related, physician-related. When the disease-related risk was perceived greater than the treatment-related risk, patients tended to report better adherence. Beliefs on efficacy and safety depended more on the patient’s experience with RA over time (severity, activity, control) than on the route of administration (oral vs sub-cutaneous). However, patients treated with JAKi needed to update their lay knowledge and skills regarding their daily constraints and medication management.For rheumatologists, JAKi were considered a promising therapeutic option, but rarely prescribed so far due to a lack of personal experience. Owing to their recent introduction on the market (~2 years in France), JAKi were prescribed to patients with longer disease duration and after several DMARDs lines. The rheumatologists’ conservative attitude towards JAK-i depended on risk perceptions similar to the patients’: disease-related, treatment-related and patient-related i.e their perception of patients’ abilities to manage their care (presumed skills, autonomy…).This study confirms the importance of patients’ beliefs of the balance between medication necessity and risks regarding safety and adherence (ref2) which are shared with the rheumatologists. This study unexpectedly emphasized a doctor-related risk in patients as well as a patient-related risk in rheumatologists. One limitation is a bias in the recruitment of patients with long-standing RA.Conclusion:Rheumatologist-patient collaboration needs a shared vision of medication risks, independently of the route of administration. However new skills are needed for patients treated with JAKi. This qualitative study will serve to modify the Hiboot application to include the JAKi issues such as the reminders or daily life management.References:[1]Beauvais C et al EULAR 2019.[2]Neame R et al. Oxford Rheumatology. 2005.Acknowledgments:French Society of Rheumatology with institutional funding by Abbvie, Lilly, Pfizer.Disclosure of Interests:Guillaume Montagu: None declared, Sophie Gleizes: None declared, Thao Pham Speakers bureau: Novartis, Janssen, Lilly, Jérémie SELLAM: None declared, Catherine Beauvais Speakers bureau: Abbvie, MSD, Roche, UCB, Mylan, Sanofi
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Molto A, Gossec L, Poiraudeau S, Claudepierre P, Soubrier M, Fayet F, Wendling D, Gaudin P, Dernis E, Guis S, Pouplin S, Ruyssen A, Chales G, Mariette X, Beauvais C, Combe B, Flipo RM, Richette P, Chary-Valckenaere I, Saraux A, Sibilia J, Schaeverbeke T, Dougados M. Evaluation of the impact of a nurse-led program of systematic screening of comorbidities in patients with axial spondyloarthritis: The results of the COMEDSPA prospective, controlled, one year randomized trial. Semin Arthritis Rheum 2020; 50:701-708. [PMID: 32521324 DOI: 10.1016/j.semarthrit.2020.05.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To evaluate the impact of a nurse-led program of systematic screening for the management (detection/prevention) of comorbidities. METHODS Prospective, randomized, controlled, open, 12-month trial (NCT02374749). PARTICIPANTS consecutive patients with axial Spondyloarthritis (axSpA) (according to the rheumatologist) THE PROGRAM: A nurse collected data on comorbidities during a specific outpatient visit. In the event of non-agreement with recommendations, the patient was informed and a specific recommendation was given to the patient (orally and in a with a detailed written report). Patients were seen after one year in a nurse-led visit. TREATMENT ALLOCATION: random allocation (i.e. either this program or an educational program not presented here and considered here as the control group). MAIN OUTCOME change after one year of a weighted comorbidity management score (0 to 100 where 0= optimal management). RESULTS 502 patients were included (252 and 250 in the active and control groups, respectively): age: 47±12 years, male gender: 63%, disease duration: 14±11y. After one year, no differences were observed in a weighted comorbidity management score. However, the number of patients in agreement with recommendations was significantly higher in the active group for vaccinations (flu vaccination: 28.6% vs. 9.9%, p<0.01; pneumococcal vaccination:40.0% vs. 21.1%,p=0.04), for cancer screening (skin cancer screening: 36.3% vs. 17.2%, p=0.04) and for osteoporosis (bone densitometry performed: 22.6% vs. 8.7%, p<0.01; Vitamin D supplementation initiation: 51.9% vs. 9.4%, p<0.01). CONCLUSIONS AND RELEVANCE This study suggests the short-term benefit of a single-visit nurse-led program for systematic screening of comorbidities for its management in agreement with recommendations, even in this young population of patients with axSpA.
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Affiliation(s)
- Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université de Paris, INSERM U-1153, CRESS, Paris, France.
| | - Laure Gossec
- Sorbonne Université, IPLESP, INSERM, Paris France; Pitié Salpêtrière hospital, APHP, Rheumatology department, Paris, France
| | - Serge Poiraudeau
- Rehabilitation and Physical Medicine Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Pascal Claudepierre
- Rheumatology Department, Henri Mondor Hospital, Assistance Publique Hôpitaux de Paris, and Université Paris Est Créteil, EA, 7379 - EpidermE, F-94010, Créteil, France
| | - Martin Soubrier
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Françoise Fayet
- Rheumatology Department, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Daniel Wendling
- Rheumatology Department, CHRU de BESANCON, University Teaching Hospital, and Université Bourgogne Franche-Comté, EA4266 (EPILAB), Besançon, France
| | | | | | | | | | - Adeline Ruyssen
- Centre de Rhumatologie, Hôpital Purpan, Toulouse, et Faculté de Médecine, Université Toulouse III, Paul Sabatier University, Toulouse, France
| | - Gerard Chales
- Medecine Faculty, Department of Rheumatology, South Hospital, Rennes 1 University, Rennes, France
| | - Xavier Mariette
- Rheumatology Department, APHP, Bicêtre Hospital, Le Kremlin-Bicetre, France
| | | | - Bernard Combe
- Rheumatology department, CHU Montpellier, Montpellier University, Montpellier, France
| | - René-Marc Flipo
- Rheumatology Department, CHU Roger Salengro Hospital, University of Lille, Lille, France
| | - Pascal Richette
- Université Paris Diderot, UFR médicale, Paris, France; APHP Hôpital Lariboisiére, Fédération de Rhumatologie, Paris, France
| | | | - Alain Saraux
- Rheumatology Unit, UMR1227 (Lymphocytes B et Autoimmunité), Université de Brest, Inserm, CHU Brest, LabEx IGO, Brest, France
| | - Jean Sibilia
- Department of Rheumatology, Hautepierre CHU, Fédération de médecine translationnelle, UMR INSERM 1109, Strasbourg, France
| | | | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Paris, France; Université de Paris, INSERM U-1153, CRESS, Paris, France
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Gossec L, Fayet F, Soubrier M, Foissac F, Molto A, Richette P, Beauvais C, Ruyssen-Witrand A, Perdriger A, Chary-Valckenaere I, Mouterde G, Dernis E, Euller-Ziegler L, Flipo RM, Gilson M, Balandraud N, Mariette X, Pouplin S, Marhadour T, Schaeverbeke T, Sordet C, Dougados M. Is self-assessment by patients of disease activity acceptable over the long term in rheumatoid arthritis? A 3-year follow-up of 771 patients. Rheumatology (Oxford) 2020; 58:1498-1499. [PMID: 30915463 DOI: 10.1093/rheumatology/kez094] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2019] [Indexed: 11/15/2022] Open
Affiliation(s)
- Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université, INSERM UMR S 1136.,Rheumatology Department, Pitié Salpêtrière Hospital, APHP, Paris
| | - Françoise Fayet
- Department of Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Martin Soubrier
- Department of Rheumatology, CHU Clermont-Ferrand, Clermont-Ferrand
| | - Frantz Foissac
- Assistance Publique-Hôpitaux de Paris, Clinical Research Unit Necker-Cochin.,Sorbonne Paris Cité, EA7323, University Paris Descartes
| | - Anna Molto
- Rheumatology Department, Cochin Hospital, AP-HP.,INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris Descartes University
| | - Pascal Richette
- UFR médicale, Université Paris Diderot, Paris; Fédération de Rhumatologie, APHP Hôpital Lariboisiére, Paris
| | - Catherine Beauvais
- Sorbonne Université, INSERM UMRS938, Paris; Rheumatology Department, St-Antoine Hospital, AP-HP, DHU i2B, Paris
| | | | - Aleth Perdriger
- Department of Rheumatology, South Hospital, Medecine Faculty, Rennes 1 University, Rennes
| | | | - Gaël Mouterde
- Rheumatology Department, Montpellier Hospital, Univ Montpellier, Montpellier
| | | | | | - René-Marc Flipo
- Department of Rheumatology, CHU Roger Salengro Hospital, University of Lille 2, Lille
| | - Mélanie Gilson
- Department of Rheumatology, Grenoble-Alpes University Hospital, Echirolles
| | | | - Xavier Mariette
- Department of Rheumatology, AP-HP, Hôpitaux Universitaires Paris-Sud, Université Paris-Sud, INSERM UMR1184, Le Kremlin-Bicetre
| | | | - Thierry Marhadour
- Department of Rheumatology, CHU de la Cavale Blanche, Boulevard Tanguy Prigent, Brest; INSERM 1227, Université Bretagne Occidentale, Brest
| | - Thierry Schaeverbeke
- Department of Rheumatology, Pellegrin Hospital, Bordeaux University, CNRS 5164, Bordeaux
| | - Christelle Sordet
- Department of Rheumatology, Hautepierre Hospital, Hopitaux Universitaire de Strasbourg, Fédération de médecine translationnelle, UMR INSERM 1109, Strasbourg, France
| | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, AP-HP.,INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris Descartes University
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Untas A, Vioulac C, Boujut E, Delannoy C, Poivret D, Rat AC, Beauvais C, Giraudet Le Quintrec JS. What Is Relatives' Role in Arthritis Management? A Qualitative Study of the Perceptions of Patient-Relative Dyads. Patient Prefer Adherence 2020; 14:45-53. [PMID: 32021116 PMCID: PMC6955756 DOI: 10.2147/ppa.s231919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Accepted: 12/05/2019] [Indexed: 12/03/2022] Open
Abstract
PURPOSE The main aim of patient education is to maintain or improve quality of life. It is mostly focused on patients even if families might be included. The aim of this study was to explore patients' and relatives' perceptions and experiences about the role of relatives in disease management in chronic inflammatory arthritis in order to provide insight into how patient education programs might include relatives. METHODS Individual semi-structured interviews were conducted with 20 patients (13 with polyarthritis; 7 with spondyloarthritis) and one of their relatives (N=40). A thematic analysis following an inductive approach was carried out using the QDA-Miner Software (inter-coder agreement 0.7). RESULTS The analysis revealed three relevant themes. The first was their perception of relatives' general roles, which included technical skills, knowledge about the disease and interpersonal skills. The other two themes dealt with their specific relationship: the dyad relationship (including the usual relationship and in the context of the disease) and the help relationship (including practical assistance and emotional help). CONCLUSION The results show the wide-ranging role of relatives in practical and emotional support, the complexity of patient-relative interactions regarding requests for help, their relationship and ability to share difficulties. This study gives indications about how to include relatives in TPE programs and emphasizes the importance of developing interventions for patient-relative dyads regarding the practical and emotional management of the disease, as well as interactions concerning help. Those interventions should enhance patients and relatives' quality of life.
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Affiliation(s)
- Aurélie Untas
- Université de Paris, LPPS, Boulogne-BillancourtF-92100, France
- Correspondence: Aurélie Untas Laboratory of Psychopathology and Health Processes EA 4057, Université de Paris, 71 Avenue Edouard Vaillant, Boulogne-Billancourt92100, FranceTel +33 176533050 Email
| | | | - Emilie Boujut
- Université de Paris, LPPS, Boulogne-BillancourtF-92100, France
| | | | - Didier Poivret
- Rheumatology Department, Hospital of Metz-Thionville, Metz, France
| | - Anne-Christine Rat
- Université de Lorraine, Paris Descartes University, EA 4360 APEMAC, Nancy, France
- Centre Hospitalier Universitaire Caen Normandie, Caen, France
| | - Catherine Beauvais
- Rheumatology Department, Saint Antoine Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
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Beauvais C, Poivret D, Lespessailles E, Thevenot C, Aubraye D, Euller Ziegler L, Beranger M, Filaire E, Gendarme S, Legrand K, Magar Y, Rousière M, Lévy-Weil F, Cortet B, Rat AC. Understanding Patients' Perspectives and Educational Needs by Type of Osteoporosis in Men and Women and People with Glucocorticosteroid-Induced Osteoporosis: A Qualitative Study to Improve Disease Management. Calcif Tissue Int 2019; 105:589-608. [PMID: 31506706 DOI: 10.1007/s00223-019-00607-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Accepted: 08/22/2019] [Indexed: 01/18/2023]
Abstract
The aim of the study was to investigate similarities and differences in health beliefs, experiences and educational needs by type of osteoporosis (OP), particularly in people with glucocorticoid-induced OP (GIOP) and men. A qualitative study was conducted via focus groups involving post-menopausal women with or without osteoporotic fractures, osteoporotic men and people with GIOP. Fifty-three participants were included in eight groups. A wide range of health beliefs was found for all types of OP. Osteoporosis was considered a natural consequence of ageing except in men or conversely a serious disease associated with risk of new fractures and disability. GIOP patients had heterogeneous knowledge of OP and reported fewer prevention behaviours, and their quality of life was affected by the causal illness. Men had difficulties coping with the loss of their functional abilities and felt that OP was a "women's" disease. Beliefs about treatments ranged from confidence to fear of adverse effects or doubt about efficacy in all types of OP. Participants were interested in physical activity, fall prevention and diet, and preferred group sessions. GIOP patients and men had an interest in face-to-face education. Men were also interested in brief information including via the Internet. Patients' beliefs about OP differed by type of OP. Specific populations such as men or people with GIOP need particular care owing to experiences and needs. Offering group sessions in educational interventions is of interest to allow for sharing experiences and also face-to-face education for men and GIOP patients or the Internet for men.
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Affiliation(s)
- Catherine Beauvais
- Rheumatology Department, Hôpital Universitaire Saint Antoine, APHP, Paris, France.
| | - Didier Poivret
- Rheumatology Department, Centre Hospitalier régional Metz-Thionville, Thionville, France
| | - Eric Lespessailles
- Rheumatology Department, Centre Hospitalier Régional, Orléans La Source, France
| | | | - Dominique Aubraye
- Rheumatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | | | - Martine Beranger
- Rheumatology Department, Centre Hospitalier Régional, Orléans La Source, France
| | - Edith Filaire
- CIAMS, Universite Paris Sud, Université Paris-Saclay, Orsay Cedex, France
- CIAMS, Université d'Orleans, Orleans, France
- INRA, UNH, Unite de Nutrition Humaine, CRNH Auvergne, Université Clermont Auvergne, Clermont-Ferrand, France
| | - Sophie Gendarme
- Centre Hospitalier régional Universitaire de Nancy, INSERM, CIC Epidémiologie clinique, Nancy, France
| | - Karine Legrand
- Centre Hospitalier régional Universitaire de Nancy, INSERM, CIC Epidémiologie clinique, Nancy, France
| | | | - Mickael Rousière
- Rheumatology Department, Hôpital Universitaire Saint Antoine, APHP, Paris, France
| | - Florence Lévy-Weil
- Rheumatology Department, Centre Hospitalier Victor Dupouy, Argenteuil, France
| | - Bernard Cortet
- Centre Hospitalier Universitaire C.H.U. Lille and Université Lille 2, Rheumatology Department and EA 4490, 59000, Lille, France
| | - Anne Christine Rat
- Université de Lorraine, APEMAC, 54000, Nancy, France
- CHU Caen Rheumatology Department, INSERM, CHRU Nancy, CIC 1433 Epidémiologie clinique, Caen, France
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Brignon M, Vioulac C, Boujut E, Delannoy C, Beauvais C, Kivits J, Poivret D, Giraudet Le Quintrec JS, Untas A, Rat AC. Patients and relatives coping with inflammatory arthritis: Care teamwork. Health Expect 2019; 23:137-147. [PMID: 31774612 PMCID: PMC6978873 DOI: 10.1111/hex.12982] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 09/13/2019] [Accepted: 09/16/2019] [Indexed: 11/27/2022] Open
Abstract
Objective To explore how patients and relatives experience and talk together about their life with inflammatory arthritis. Design Qualitative research. Setting A convenience sample was used. Participants were recruited in seven rheumatology departments in France. Participants Patients with rheumatoid arthritis or spondyloarthritis, agreeing to participate in the study with a relative, age at least 18 years. Data collection and analysis Two psychologists conducted face‐to‐face interviews with 20 patient‐relative dyads (40 individuals). A thematic analysis followed a general inductive approach. Results Saturation was reached after interviews with 20 dyads. The analysis revealed four main themes: (a) disease ‘lived’ together: a new role for the relative (providing help in physical tasks, emotional support, acting as a driving force, having a role in medical care) and communication around the disease (not focusing on the disease); (b) impact of the disease on the relationship; (c) social impact of the disease on the dyad (social isolation); (d) difficulties and needs of the relative (need to better know the disease). Conclusion This study has highlighted the importance of recognizing the role of the relative in the management of inflammatory arthritis disease, especially when medical decisions are shared with professionals. A joint approach to treatment is a basis for coping with the disease. This approach supposes (a) discussions about relatives’ new roles to clarify them, (b) patients’ and relatives’ communication skills and (c) a good understanding of each other, which can be improved by providing information on the disease and coping strategies for both the patient and the relative.
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Affiliation(s)
| | - Christel Vioulac
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Emilie Boujut
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | | | - Catherine Beauvais
- Hôpitaux universitaires Est Parisien, AP-HP, Rheumatology Department, Saint-Antoine Hospital, Paris, France
| | - Joelle Kivits
- EA 4360 APEMAC, Université de Lorraine, Nancy, France
| | | | | | - Aurélie Untas
- Laboratory of Psychopathology and Health Processes EA 4057, University of Paris Descartes - Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Anne-Christine Rat
- EA 4360 APEMAC, Université de Lorraine, Nancy, France.,Rheumatology Department, University Hospital Nancy, Nancy, France
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Beauvais C, Rodère M, Pereira B, Legoupil N, Piperno M, Pallot Prades B, Castaing P, Wendling D, Grange L, Costantino F, Carton L, Soubrier M, Coquerelle P, Pham T, Poivret D, Cohen JD, Tavares I, Nataf H, Pouplin S, Sordet C, Gossec L. Essential knowledge for patients with rheumatoid arthritis or spondyloarthritis: Results of a multicentric survey in France among health professionals and patients. Joint Bone Spine 2019; 86:747-752. [DOI: 10.1016/j.jbspin.2019.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/05/2019] [Indexed: 12/13/2022]
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López-Medina C, Moltó A, Gérald F, Dubremetz M, Grange L, Thibaud G, Charles B, Lafarge D, Beauvais C, Gossec L, Dougados M. Assessment of the adherence to disease-modifying drugs in patients with chronic inflammatory rheumatic diseases: Results of a survey of 1594 patients. Joint Bone Spine 2019; 86:610-614. [DOI: 10.1016/j.jbspin.2019.01.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 01/30/2019] [Indexed: 12/22/2022]
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Beauvais C, Gossec L, Mulliez A, Fayet F, Poilverd RM, Pouplin S, Perrot S, L'amour C, Carton L, Aubert MP, Miconnet S, Grange L, Flipon-Cousin E, Mézieres M, Dougados M, Jaccaz-Vallée N, Savel C. Self-reported competencies and educational needs of rheumatology nurses: Results of a national survey. Joint Bone Spine 2019; 87:91-93. [PMID: 31279742 DOI: 10.1016/j.jbspin.2019.06.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/19/2019] [Indexed: 10/26/2022]
Affiliation(s)
- Catherine Beauvais
- Rheumatology Department, Saint-Antoine University Hospital, DHU i2B, AP-HP, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France.
| | - Laure Gossec
- Sorbonne université, institut Pierre-Louis d'épidémiologie et de santé publique, 75013 Paris, France
| | - Aurélien Mulliez
- Biostatistic Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Françoise Fayet
- Rheumatology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | - Rose Marie Poilverd
- Rheumatology Department, Saint-Antoine University Hospital, DHU i2B, AP-HP, 184, rue du Faubourg Saint-Antoine, 75012 Paris, France
| | - Sophie Pouplin
- Rheumatology Department, University Hospital, 76000 Rouen, France
| | - Serge Perrot
- Medicine Department, University René-Descartes, University Hospital Cochin, 75014 Paris, France
| | - Christian L'amour
- Rheumatology Department, Pitié-Salpêtrière University Hospital, AP-HP, 75013 Paris, France
| | - Laurence Carton
- Association AFLAR Association de Lutte Anti-Rhumatismale, 75013 Paris, France
| | - Marie Pierre Aubert
- Rheumatology Department, University Hospital Hôtel-Dieu, 44000 Nantes, France
| | - Sylvie Miconnet
- Rheumatology Department, Bicêtre University Hospital, AP-HP, 94270 Le Klemlin-Bicêtre, France
| | - Laurent Grange
- Rheumatology Department, University Hospital Grenoble-Alpes, 38130 Échirolles, France
| | | | - Maryse Mézieres
- Rheumatology Department, University Hospital Cochin, 75014 France
| | - Maxime Dougados
- Rheumatology Department, University Hospital Cochin, University René-Descartes, 75014 France
| | - Nelly Jaccaz-Vallée
- Rheumatology Department, University Hospital Bretonneau, 37000 Tours, France
| | - Carine Savel
- Rheumatology Department, University Hospital Gabriel-Montpied, 63000 Clermont-Ferrand, France
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Gossec L, Soubrier M, Foissac F, Molto A, Richette P, Beauvais C, Ruyssen-Witrand A, Perdriger A, Chary-Valckenaere I, Mouterde G, Dernis E, Euller-Ziegler L, Flipo RM, Gilson M, Guis S, Mariette X, Pouplin S, Marhadour T, Schaeverbeke T, Sordet C, Fayet F, Dougados M. Screening for and management of comorbidities after a nurse-led program: results of a 3-year longitudinal study in 769 established rheumatoid arthritis patients. RMD Open 2019; 5:e000914. [PMID: 31275607 PMCID: PMC6579559 DOI: 10.1136/rmdopen-2019-000914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 04/03/2019] [Accepted: 04/23/2019] [Indexed: 12/20/2022] Open
Abstract
Background/purpose Cardiovascular (CV) risk, cancer, infections and osteoporosis should be screened for in rheumatoid arthritis (RA). The objective was to assess 3-year effects of a nurse visit for comorbidity counselling. Methods This was an open long-term (3 years) extension of the Comorbidities and Education in Rheumatoid Arthritis 6-month randomised controlled trial in which patients with definite, stable RA were visiting a nurse for comorbidity counselling. Comorbidity status was assessed and nurses provided advice on screening and management, at baseline and 3 years later. A score was developed to quantify comorbidity screening and management: 0–100, where lower scores indicate better screening and management. The score was compared between baseline and 3-year assessment using a Wilcoxon test for paired data. Results Of the 970 recruited patients, 776 (80%) were followed-up at 2–4 years and 769 (79%) had available data for comorbidities at both time points: mean (±SD) age 58 (±11) years and mean disease duration 14 (±10) years; 614 (80%) were women, the mean Disease Activity Score 28 was 3.0±1.3, and 538 (70%) were receiving a biologic. At baseline, the mean comorbidity screening score was 36.6 (±19.9) and it improved at 3 years to 24.3 (±17.8) (p<0.0001), thus with a relative improvement of 33% (improvement of 12 points). CV risk screening, vaccination status and bone densitometry performance improved the most. Conclusions Comorbidity screening was suboptimal but improved notably over 3 years, after a nurse-led programme aiming at checking systematically for comorbidity screening and giving patient advice. This long-term efficacy pleads in favour of nurse-led interventions to better address comorbidities in RA. Trial registration number NCT01315652
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Affiliation(s)
- Laure Gossec
- Sorbonne Universite, Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Paris, France.,Rheumatology, Pitie Salpetriere Hospital, AP-HP, Paris, France
| | - Martin Soubrier
- Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Frantz Foissac
- Clinical Research Unit Necker-Cochin, Assistance Publique-Hopitaux de Paris, Paris, Île-de-France, France
| | - Anna Molto
- Rheumatology, Cochin Hospital, AP-HP, Paris, France.,INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris Descartes University, Paris, France
| | - Pascal Richette
- Rheumatology, Lariboisiere Hospital AP-HP, Paris, France.,Inserm UMR1132 Bioscar, Universite Paris Diderot, Paris, France
| | - Catherine Beauvais
- Rheumatology, Sorbonne Université and Hopital Saint-Antoine AP-HP, Paris, France
| | - Adeline Ruyssen-Witrand
- Rheumatology, UMR 1027 Inserm, Paul Sabatier University and Purpan Hospital, Toulouse, France
| | - Aleth Perdriger
- Rheumatology, South Hospital, Rennes 1 University, Rennes, France
| | | | - Gael Mouterde
- Immuno-rhumatologie, Lapeyronie Hospital and Montpellier University, Montpellier, France
| | | | | | - René-Marc Flipo
- Rheumatology, R Salengro Hospital, University of Lille, Lille, France
| | - Mélanie Gilson
- Rheumatology, GREPI-CNRS, Grenoble Hospital and Université Joseph Fourier, Echirolles, France
| | - Sandrine Guis
- Rheumatology, University Hospital, AP-HM, Marseille, France
| | - Xavier Mariette
- Rheumatology, HôpitauxUniversitaires Paris-Sud, Université Paris-Sud, INSERM UMR1184, Le Kremlin Bicetre, France
| | | | - Thierry Marhadour
- Rheumatology, Cavale Blanche Hospital and INSERM 1227, Université Bretagne Occidentale, Brest, France
| | - Thierry Schaeverbeke
- Rheumatology, Pellegrin Hospital, Bordeaux University, CNRS 5164, Bordeaux, France
| | - Christelle Sordet
- Rheumatology, Hautepierre Hospital, Fédération de médecine translationnelle, UMR INSERM 1109, Strasbourg, France
| | - Françoise Fayet
- Rheumatology, Gabriel Montpied University Hospital, Clermont-Ferrand, France
| | - Maxime Dougados
- Rheumatology, Cochin Hospital, AP-HP, Paris, France.,INSERM (U1153), Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris Descartes University, Paris, France
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Lavielle M, Puyraimond-Zemmour D, Romand X, Gossec L, Senbel E, Pouplin S, Beauvais C, Gutermann L, Mezieres M, Dougados M, Molto A. Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review. RMD Open 2018; 4:e000684. [PMID: 30116556 PMCID: PMC6088346 DOI: 10.1136/rmdopen-2018-000684] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 01/24/2023] Open
Abstract
Objective Lack of adherence to treatment is frequent in chronic inflammatory rheumatic diseases and is associated with poorer outcomes. The objective of this study was to describe and evaluate interventions that have been proposed to enhance medication adherence in these conditions. Methods A systematic literature review was performed in Pubmed, Cochrane, Embase and clinicaltrials.gov databases completed by the rheumatology meeting (ACR, EULAR and SFR) abstracts from last 2 years. All studies in English or French evaluating an intervention to improve medication adherence in chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondyloarthritis (SpA), crystal related diseases, connective tissue diseases, vasculitis and Still's disease) were included. Interventions on adherence were collected and classified in five modalities (educational, behavioural, cognitive behavioural, multicomponent interventions or others). Results 1325 abstracts were identified and 22 studies were finally included (18 studies in RA (72%), 4 studies in systemic lupus erythematosus (16%), 2 studies in SpA (8%) and 1 study in gout (4%)). On 13 randomised controlled trials (RCT) (1535 patients), only 5 were positive (774 patients). Educational interventions were the most represented and had the highest level of evidence: 8/13 RCT (62%, 1017 patients) and 4/8 were positive (50%). In these studies, each patient was individually informed or educated by different actors (physicians, pharmacists, nurses and so on). Supports and contents of these educational interventions were heterogenous. Conclusion Despite the importance of medication adherence in chronic inflammatory rheumatic disorders, evidence on interventions to improve medication adherence is scarce.
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Affiliation(s)
- Matthieu Lavielle
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France
| | | | - Xavier Romand
- Rheumatology Department, Centre Hospitalier Universitaire Grenoble Alpes, Hôpital Sud, Echirolles, France
| | - Laure Gossec
- Sorbonne University, Paris, France.,Rheumatology Department, Pitié Salpêtrière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Senbel
- Rheumatology Department, Sainte Marguerite Hospital, Assistance Publique-Hôpitaux de Marseille, Marseille, France
| | - Sophie Pouplin
- Rheumatology Department, Hôpitaux de Rouen, Rouen, France
| | - Catherine Beauvais
- Rheumatology Department, Saint-Antoine Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Loriane Gutermann
- Pharmacy Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maryse Mezieres
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Maxime Dougados
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Paris Descartes University, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
| | - Anna Molto
- Rheumatology Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Paris Descartes University, Paris, France.,Paris Descartes University, INSERM (U1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France
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Gossec L, Cantagrel A, Soubrier M, Berthelot JM, Joubert JM, Combe B, Czarlewski W, Wendling D, Dernis E, Grange L, Beauvais C, Perdriger A, Nataf H, Dougados M, Servy H. An e-health interactive self-assessment website (Sanoia ®) in rheumatoid arthritis. A 12-month randomized controlled trial in 320 patients. Joint Bone Spine 2017; 85:709-714. [PMID: 29246532 DOI: 10.1016/j.jbspin.2017.11.015] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 11/29/2017] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Sanoia is an online interactive electronic e-health platform developed to allow patient self-assessment and self-monitoring. The objective was to assess in rheumatoid arthritis (RA) patients, the efficacy on patient-physician interactions, of giving access to Sanoia. METHODS In this French, multi-center, 12-months randomized controlled trial (CarNET: NCT02200068), patients with RA and internet access were randomized to: access without incentives to the Sanoia platform after minimal training, or usual care. The primary outcome was the change from baseline in patient-physician interactions, by the patient-reported Perceived Efficacy in Patient-Physician Interactions (PEPPI-5) questionnaire. The number of accesses to Sanoia was recorded and satisfaction with the platform was assessed through a 0-10 numeric rating scale. Analyses were in intention to treat (ITT), on SAS. RESULTS Of 320 RA patients (159 Sanoia versus 161 usual care), mean (standard deviation) age was 57.0 (12.7) years, mean (SD) disease duration was 14.6 (11.1) years, 216 (67.5%) were taking a biologic and 253 (79.1%) were female. Mean (SD) PEPPI scores at baseline and 12 months were 38.6 (8.2) and 39.2 (8.0) (delta=+0.60 [5.52]) versus 39.7 (7.3) and 38.8 (8.0) (delta=-0.91 [6.08]) in the Sanoia and control group, respectively (P=0.01). Although mean satisfaction with the platform was very high (1.46 [1.52]), 41 patients (25.7%) never accessed Sanoia. CONCLUSION Giving RA patients access to the interactive Sanoia e-health platform led to a small improvement in patient-perceived patient-physician interactions. A disjunction between patient satisfaction and access to the platform was noted. E-Health platforms are promising in RA.
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Affiliation(s)
- Laure Gossec
- Institut Pierre-Louis d'épidémiologie et de santé publique (UMRS 1136), Sorbonne universités, UPMC université Paris 06, GRC-UPMC 08 (EEMOIS), 75013 Paris, France; Rheumatology department, hôpital Pitié-Salpêtrière, AP-HP, 75013 Paris, France.
| | - Alain Cantagrel
- Rheumatology department, hôpital de Purpan, CHU de Toulouse, 31300 Toulouse, France
| | - Martin Soubrier
- Rheumatology department, CHU Gabriel-Montpied, 63000 Clermont-Ferrand, France
| | | | | | - Bernard Combe
- Rheumatology department, hôpital Lapeyronie, Montpellier université, 34295 Montpellier cedex 5, France
| | | | - Daniel Wendling
- Rheumatology department, CHRU Jean-Minjoz, 25030 Besançon, France
| | - Emmanuelle Dernis
- Rheumatology department, centre hospitalier du Mans, 72037 Le Mans, France
| | - Laurent Grange
- Rheumatology department, CHU Grenoble Alpes-hôpital Sud, 38130 Echirolles, France
| | - Catherine Beauvais
- Rheumatology department, hopital Saint-Antoine, AP-HP, 75012 Paris, France
| | - Aleth Perdriger
- Rheumatology department, CHR hôpital Sud, 35033 Rennes cedex 9, France
| | - Henri Nataf
- Private practice rheumatology, 78200 Mantes-La-Jolie, France
| | - Maxime Dougados
- Paris descartes university, 75014 Paris, France; Department of rheumatology, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 75014 Paris, France; Inserm (U1153), clinical epidemiology and biostatistics, PRES Sorbonne Paris-Cité, 75014 Paris, France
| | - Hervé Servy
- Sanoia, e-Health services, 13420 Gémenos, France
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de Pokomandy A, Rouleau D, Lalonde R, Beauvais C, de Castro C, Coutlée F. Argon plasma coagulation treatment of anal high-grade squamous intraepithelial lesions in men who have sex with men living with HIV: results of a 2-year prospective pilot study. HIV Med 2017; 19:81-89. [PMID: 28833949 DOI: 10.1111/hiv.12544] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Men who have sex with men (MSM) living with HIV are at high risk for anal high-grade squamous intraepithelial lesions (HSILs) and cancer. The best management of anal HSIL remains unclear. Our objective was to assess whether argon plasma coagulation (APC) could be safe, well tolerated and efficient to treat anal HSILs in MSM living with HIV. METHODS A prospective phase II, open-label, pilot study was conducted to evaluate APC to treat anal HSILs in 20 HIV-positive MSM. Participants were followed for 2 years after their first treatment. RESULTS Twenty men with persistent HSILs completed the 2-year study. Their baseline median CD4 count was 490 cells/μL and 85% had undetectable HIV viral loads. Overall, 65% (13/20) of participants were clear of HSILs at their 24-month visit. The initial response rates after the first, second and third APC treatments were 45%, 44% and 67%, respectively, but recurrences were common. The main side effect was pain during and within 1 week after the treatments. There were no long-term side effects, nor serious adverse events related to the procedure. Cost is a drawback. CONCLUSIONS APC can be used to treat anal HSILs in HIV-seropositive MSM, and requires repeated treatment because of a high recurrence rate. As successful treatment of human papillomavirus (HPV) infection or eradication of the anal transitional zone remains impossible, HSIL treatment is challenging and requires long-term follow-up.
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Affiliation(s)
- A de Pokomandy
- Family Medicine Department, McGill University, Montreal, QC, Canada.,Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Canadian Institutes of Health Research (CIHR) - Canadian HIV Trials Network, Vancouver, BC, Canada
| | - D Rouleau
- Canadian Institutes of Health Research (CIHR) - Canadian HIV Trials Network, Vancouver, BC, Canada.,Department of Microbiology and Infectious Diseases, Centre Hospitalier de l'Université de Montréal (University of Montreal Hospital Centre), University of Montreal, Montreal, QC, Canada.,Unité Hospitalière de Recherche et Enseignement en Soins Sida (AIDS Care Research and Teaching Hospital Unit) of Centre Hospitalier de l'Université de Montréal (University of Montreal Hospital Centre), Montreal, QC, Canada
| | - R Lalonde
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Canadian Institutes of Health Research (CIHR) - Canadian HIV Trials Network, Vancouver, BC, Canada.,Department of Infectious Diseases, McGill University and McGill University Health Centre, Montreal, QC, Canada
| | - C Beauvais
- Unité Hospitalière de Recherche et Enseignement en Soins Sida (AIDS Care Research and Teaching Hospital Unit) of Centre Hospitalier de l'Université de Montréal (University of Montreal Hospital Centre), Montreal, QC, Canada
| | - C de Castro
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada
| | - F Coutlée
- Chronic Viral Illness Service, McGill University Health Centre, Montreal, QC, Canada.,Department of Infectious Diseases, McGill University and McGill University Health Centre, Montreal, QC, Canada
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Vliet Vlieland TPM, van den Ende CHM, Alliot-Launois F, Beauvais C, Gobbo M, Iagnocco A, Lundberg IE, Munuera-Martínez PV, Opava CH, Prior Y, Redmond A, Smucrova H, Wiek D. Educational needs of health professionals working in rheumatology in Europe. RMD Open 2016; 2:e000337. [PMID: 27933210 PMCID: PMC5133422 DOI: 10.1136/rmdopen-2016-000337] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 10/12/2016] [Accepted: 10/22/2016] [Indexed: 11/12/2022] Open
Abstract
Objective To explore the availability of postgraduate education for health professionals (HPs) working in rheumatology in Europe, and their perceived educational needs and barriers for participation in current educational offerings. Methods Structured interviews were conducted with national representatives of rheumatology HPs' organisations and an online survey among individual HPs was disseminated through existing European League Against Rheumatism (EULAR) networks (10 languages including English). These comprised questions on: availability of postgraduate education, familiarity with EULAR and its educational offerings, unmet needs regarding the contents and mode of delivery and potential barriers to participate in education (0–10 scales). Results According to 17 national representatives, postgraduate rheumatology education was most common for nurses, physical and occupational therapists. There were 1041 individuals responding to the survey, of whom 48% completed all questions. More than half (56%) were familiar with EULAR as an organisation, whereas <25% had attended the EULAR congress or were familiar with EULAR online courses. Educational needs regarding contents were highest for ‘inflammatory arthritis’ and ‘connective tissue diseases’ and regarding modes of delivery for ‘courses organised in own country’ and ‘online courses’. Important barriers to participation included lack of ‘resources’, ‘time’ and ‘English language skills’. Overall, there was considerable variation in needs and barriers among countries. Conclusions There is a lack of postgraduate rheumatology education for HPs in most countries. There are opportunities to raise awareness regarding EULAR educational offerings and to develop courses provided in HPs' own country, tailored to national needs and barriers and taking language barriers into consideration.
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Affiliation(s)
- Theodora P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy , Leiden University Medical Center , Leiden , The Netherlands
| | | | | | - Catherine Beauvais
- Department of Rheumatology , Saint Antoine Hospital, Assistance Publique Hôpitaux de Paris , Paris , France
| | | | | | - Ingrid E Lundberg
- Rheumatology Unit, Department of Medicine , Karolinska University Hospital, Solna, Karolinska Institutet , Stockholm , Sweden
| | | | - Christina H Opava
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Huddinge, Sweden; Rheumatology Unit, Karolinska University Hospital, Stockholm, Sweden
| | - Yeliz Prior
- Centre for Health Sciences Research, University of Salford, Greater Manchester, UK; East Cheshire NHS Trust, Leighton Hospital, UK
| | - Anthony Redmond
- Department of Clinical Biomechanics and Physical Medicine, Leeds Institute of Rheumatic and Musculoskeletal Medicine, Leeds, UK; Leeds NIHR Biomedical Research Unit, Leeds, UK
| | - Hana Smucrova
- Department of Rehabilitation , Institute of Rheumatology , Prague , Czech Republic
| | - Dieter Wiek
- Deutsche Rheuma-Liga Bundesverband , Bonn , Germany
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Beauvais C, Pouplin S, Mulliez A, Fayet F, Poilverd R, Gossec L, Perrot S, L'Amour C, Mezières M, Aubert M, Jaccaz Vallée N, Savel C. SAT0627-HPR Educational Needs of French Rheumatology Nurses Are Not Limited To Inflammatory Arthritis Management. Results of The Multicentric “Caire” Survey:. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beauvais C. Include patient education in daily practice: Promoting the patient-centered care approach. Joint Bone Spine 2015; 82:219-21. [DOI: 10.1016/j.jbspin.2014.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 12/14/2014] [Indexed: 12/01/2022]
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Beauvais C, Gossec L, Mulliez A, Fayet F, Poilverd R, Pouplin S, Perrot S, L'Amour C, Mezieres M, Aubert M, Jaccaz Vallée N, Savel C. FRI0622-HPR What Competencies for Rheumatology Nurses? Results of a Multicentric Survey Among Health Professionals and Nurses in France:. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Beauvais C, Rodère M, Peirera B, Soubrier M, Gossec L. THU0579 What Knowledge is Essential for Patients with Rheumatoid Arthritis (RA) and Spondyloarthritis (SPA)? Results of a Multicentric Survey Among Health Professionals and Patients with Delphi Methodology. An Initiative of the French Rheumatology Society Therapeutic Education Section: Table 1. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Rat AC, Fautrel B, Flipon E, Gossec L, Marguerie L, Nataf H, Pallot Prades B, Poilvert R, Royant V, Sadji F, Sordet C, Thevenot C, Beauvais C. SAT0578 Patients with Rheumatoid Arthritis, Spondyloarthritis and Psoriatic Arthritis Treated with BIOLOGICS Use Similar Coping Strategies: A Study of 671 Patients:. Ann Rheum Dis 2014. [DOI: 10.1136/annrheumdis-2014-eular.4178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gossec L, Fautrel B, Flipon É, Lecoq d'André F, Marguerie L, Nataf H, Pallot Prades B, Piperno M, Poilverd RM, Rat AC, Sadji F, Sordet C, Thevenot C, Beauvais C. Safety of biologics: elaboration and validation of a questionnaire assessing patients' self-care safety skills: the BioSecure questionnaire. An initiative of the French Rheumatology Society Therapeutic Education section. Joint Bone Spine 2013; 80:471-6. [PMID: 23972274 DOI: 10.1016/j.jbspin.2012.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 11/28/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND Biologics are known to entail specific risks (e.g. infections). Patients should possess self-care safety skills to develop appropriate behaviors in situations of risks (e.g. fever). To date, there is no adequate tool to assess these skills. OBJECTIVES To elaborate a questionnaire to measure knowledge and skills regarding safety issues, for patients treated by biologics. METHODS Three-step process. (1) A steering group of 10 rheumatologists, one pharmacist and two allied health professionals elaborated an exhaustive list of safety skills. Through a 3-round Delphi process involving the steering group, 14 patients on biologics and 14 other allied health professionals, the list of skills was reduced. (2) A corresponding series of questions and of clinical situations with multiple-choice answers were designed. (3) Preliminary validation was performed against the physician's opinion on skills, and reliability was assessed. RESULTS The list includes 24 skills e.g. how to deal with fever, planned surgery, dental care, travel, minor traumas, and immunizations. A 55-question questionnaire was constructed. Preliminary validation (62 patients) showed the questionnaire was filled in 10 minutes (median) and correlated to the physician's opinion of skills (R=0.47, P<0.0001) but not to disease status or disease duration. The median score was 75% (range 20%-96%). The questionnaire was reliable: intraclass correlation coefficient, 0.83 (95% CI: 0.63-0.93). CONCLUSION A simple (multiple-choice questionnaire) and valid tool investigating a core set of safety skills has been developed. This tool could be useful to detect further educational needs regarding biologics safety, and to assess the efficacy of oriented educational interventions.
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Affiliation(s)
- Laure Gossec
- Université Pierre et Marie Curie (UPMC) - Paris 6, GRC-UMPC 08 (EEMOIS), AP-HP, Pitié Salpêtrière Hospital, Department of Rheumatology, 83, boulevard de l'hôpital, 75013 Paris, France.
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Beauvais C, Lespessailles E, Magar Y, Thevenot C, Euller Ziegler L, Filaire E, Gendarme S, Legrand K, Lévy-Weil F, Aubraye D, Cortet B, Poivret D, Rousière M, Rat AC. THU0374 Health Beliefs, Experiences and Educational Needs of Patients with Osteoporosis : A Qualitative Study by the Working Group Solid’os. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Cohen JD, Beauvais C, Hayem G, Grange L, Bertholon DR, Karrer M, Chirol S. THU0564 Peer Patient Educators within Rheumatoid Arthritis Patient Education Programs in France. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Rat AC, Fautrel B, Flipon E, Gossec L, Caritey BD, Margerie L, Nataf H, Piperno M, Pallot Prades B, Poilvert R, Royant V, Sadji F, Sordet C, Thevenot C, Beauvais C. THU0448 Safety competences knowledge and behavioural skills of patients treated by biologics in rheumatology:. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Beauvais C, Hassani K, Rahal A, Pouplin S. AB1404 Detection of patients educational needs in current practice: A prospective study among patients suffering from inflammatory arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.1396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Federspiel F, Herbin L, Alby MN, Beauvais C, Carrat F, Debrix I. CPC-018 AnETh: An Original Tool For Assessing, Promoting and Improving Your Patient Education (PE) Programme. Eur J Hosp Pharm 2013. [DOI: 10.1136/ejhpharm-2013-000276.475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Beauvais C. [Patient education in rheumatoid arthritis]. Rev Prat 2012; 62:1096-1097. [PMID: 23227608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Catherine Beauvais
- Service de rhumatologie, hôpital Saint-Antoine, AP-HP, 75012 Paris, France.
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Gossec L, Solano C, Paternotte S, Beauvais C, Gaudin P, von Krause G, Sordet C, Perdriger A. Elaboration and validation of a questionnaire (Qualisex) to assess the impact of rheumatoid arthritis on sexuality with patient involvement. Clin Exp Rheumatol 2012; 30:505-513. [PMID: 22510391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 11/28/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) may have consequences on sexual life. The objective was to develop and validate a questionnaire assessing the impact of RA on sexuality. METHODS First, 6 patients (5 women, 1 man) with RA, 2 rheumatologists and 1 sexologist elaborated during a one-day focus-group type meeting an exhaustive list of issues relating to impact of RA on sexuality. The list was reduced by merging similar issues, then according to the relative importance for patients of each issue. A questionnaire was developed with input from these patients, with particular attention on phrasing. Psychometric properties (missing data, correlations with other disease aspects, reliability) were assessed in a multi-centre study. RESULTS The list of 33 issues related to impact of RA on sexuality included psychological issues (9), couple/relationship issues (9), physical issues (7), and general aspects (5). A 10-question numeric rating scale questionnaire was constructed. Preliminary validation was obtained on 53 patients (44 women, mean age 50.7 years; mean disease duration 14.4 years). The mean score was 3.3±2.5, missing data were acceptable (13%). Qualisex results were correlated with disease activity and symptoms (r=0.50-0.65, p< 0.001); but not with demographics, depression or coping. Qualisex was reliable in 40 patients: the intra-class correlation coefficient was 0.83 (95% CI: 0.70-0.91). CONCLUSIONS A simple (10 questions) and valid tool investigating impact of RA on sexuality has been developed with the involvement of patients. This tool can be useful to assess this important aspect of quality of life.
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Affiliation(s)
- Laure Gossec
- Paris Descartes University, Rheumatology B Department, Paris France.
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Giraudet-Le Quintrec JS, Beauvais C. Patient education: An orphan finally accepted for adoption – Misconceptions and current status. Joint Bone Spine 2009; 76:584-7. [DOI: 10.1016/j.jbspin.2009.09.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2009] [Indexed: 11/16/2022]
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Narita T, Beauvais C, Hébraud P, Lequeux F. Dynamics of concentrated colloidal suspensions during drying--aging, rejuvenation and overaging. Eur Phys J E Soft Matter 2004; 14:287-292. [PMID: 15338440 DOI: 10.1140/epje/i2004-10018-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report on the slow dynamics of concentrated colloidal suspensions during drying and rewetting under conditions of reversible concentration changes without coalescence or aggregation. We used multispeckle diffusing-wave spectroscopy to monitor the slow dynamics of particles. We found that the alpha relaxation of the suspensions exhibits successively slowing-down, acceleration and a stationary regime during drying at constant rates. Under rewetting conditions, we observed slowing-down and a stationary regime. The characteristic time of the stationary regime is inversely proportional to the rate of concentration change and identical for both drying and rewetting. We explain these regimes as aging (overaging), rejuvenation and plastic flow of the suspensions induced by a deviatoric stress (a combination of compressive and elongational stresses) which is induced by the uniaxial compressive strain generated by evaporation.
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Affiliation(s)
- T Narita
- Laboratoire de Physico-chimie Macromoléculaire, CNRS UMR7615, ESPCI, 10 rue Vauquelin, 75231 Paris 05, France.
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Beauvais C, Wybier M, Chazerain P, Harboun M, Lioté F, Roucoulès J, Koeger AC, Bellaiche L, Orcel P, Bardin T, Ziza JM, Laredo JD. Prognostic value of early computed tomography in radiculopathy due to lumbar intervertebral disk herniation. A prospective study. Joint Bone Spine 2003; 70:134-9. [PMID: 12713858 DOI: 10.1016/s1297-319x(03)00021-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To prospectively evaluate the relationship between the early computerized tomography (CT) features of disk herniation and the clinical outcome in patients with recent-onset sciatic or femoral neuralgia treated conservatively. Early CT is often used, despite the absence of data on usefulness for predicting outcomes. METHODS Of 78 patients with sciatica or femoral neuralgia of less than 1 month's duration, presumably due to a disk herniation, 75 were found by CT to have a disk herniation at the expected level. All patients were treated conservatively. The 60 patients who were reassessed clinically after 3 months were included in the study. Based on the results of the clinical assessment, the patients were classified as having a good outcome (complete or partial recovery) or a poor outcome. CT findings were compared in these two groups. RESULTS None of the features of disk herniation studied on the CT scans were significantly correlated with the clinical outcome. A larger herniation or presence of a free fragment was more common in the good outcome group, but the differences were not statistically significant (P= 0.07). CONCLUSION In this study, early CT scan did not predict the clinical outcome of patients with nerve root pain from lumbar disk herniation. None of the CT criteria was associated with a poor clinical outcome. Early CT scan has no prognostic value in this setting.
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Affiliation(s)
- Catherine Beauvais
- Rheumatology Department, Saint Antoine Hospital, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
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Gonzalez C, Ménissier De Murcia J, Janiak P, Bidouard JP, Beauvais C, Karray S, Garchon HJ, Lévi-Strauss M. Unexpected sensitivity of nonobese diabetic mice with a disrupted poly(ADP-Ribose) polymerase-1 gene to streptozotocin-induced and spontaneous diabetes. Diabetes 2002; 51:1470-6. [PMID: 11978644 DOI: 10.2337/diabetes.51.5.1470] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Poly(ADP-ribose) polymerase-1 (PARP-1) is a nuclear enzyme that consumes NAD in response to DNA strand breaks. Its excessive activation seems particularly deleterious to pancreatic beta-cells, as exemplified by the complete resistance of PARP-1-deficient mice to the toxic diabetes induced by streptozotocin. Because of the possible implication of this enzyme in type 1 diabetes, many human trials using nicotinamide, an inhibitor of PARP-1, have been conducted either in patients recently diagnosed or in subjects highly predisposed to this disease. To analyze the role of this enzyme in murine type 1 diabetes, we introgressed a disrupted PARP-1 allele onto the autoimmune diabetes-prone nonobese diabetic (NOD) mouse strain. We showed that these mice were protected neither from spontaneous nor from cyclophosphamide-accelerated diabetes. Surprisingly they were also highly sensitive to the diabetes induced by a single high dose of streptozotocin, standing in sharp contrast with C57BL/6 mice that bear the same inactivated PARP-1 allele. Our results suggest that NOD mice are characterized not only by their immune dysfunction but also by a peculiarity of their islets leading to a PARP-1-independent mechanism of streptozotocin-induced beta-cell death.
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Affiliation(s)
- Cristina Gonzalez
- Institut National de la Santé et de la Recherche Médicale, Unité 25, Hôpital Necker, Paris, France
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Lévi-Strauss M, Beauvais C, Karray S. Identification of a polymorphic microsatellite marker in the mouse Fas ligand gene. Eur J Immunogenet 2001; 28:553-5. [PMID: 11881823 DOI: 10.1046/j.0960-7420.2001.00249.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe the characterization of a polymorphic microsatellite marker, located 1.8 kb downstream of exon 4 in the mouse Fas ligand gene. This (GT) repeat sequence allows the identification of four alleles which can very easily be distinguished by simple agarose electrophoresis.
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Affiliation(s)
- M Lévi-Strauss
- Institut National de la Sante et de la Recherche Médicale (INSERM), Unité 25, Hĵpital Necker Enfants Malades, Paris, France
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Fuks A, Beauvais C. Maximizing the effectiveness of REBs. NCEHR Commun 2000; 10:9-15. [PMID: 15468467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- A Fuks
- McGill University, Canada
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Prier A, Berenbaum F, Karneff A, Molcard S, Beauvais C, Dumontier C, Sautet A, Miralles MP, Peroux JL, Kaplan G. Multidisciplinary day hospital treatment of rheumatoid arthritis patients. Evaluation after two years. Rev Rhum Engl Ed 1997; 64:443-50. [PMID: 9338925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The availability of multidisciplinary care for rheumatoid arthritis is still limited. The Raoul Dufy Program offered by the Saint-Antoine Teaching Hospital in Paris provides one-on-one personalized care in a day hospital setting as an adjunct to conventional medical follow-up. Listening and providing information and education are major objectives of the nurse, rheumatologist and physical therapist participating in the program. The team also includes a social worker, a surgeon, a dietician, a podiatrist and a psychologist, who intervene as needed. Seventy patients attended the program between December 1993 and September 1995 and were asked to complete a baseline and a three-month questionnaire designed to evaluate the effects of the program in terms of new therapeutic interventions, patient knowledge and quality of life. The patient knowledge score increased significantly (P < 0.0001). Many therapeutic interventions were initiated after program attendance, especially in the fields of podiatry, psychology and physical therapy. However, the quality of life score failed to improve. These results and the substantial patient demand for appointments are encouraging. Further work is needed on the methodology of multidisciplinary care evaluation. Coping strategy evaluation tools may allow to identify some of the specific benefits provided by the multidisciplinary approach.
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Affiliation(s)
- A Prier
- Rheumatology Department, Saint-Antoine Teaching Hospital, Paris, France
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Benharrats I, Beauvais C, Baudrimont M, Jacob L. [C5-C6 peripheral neuropathy disclosing Horton disease]. Ann Med Interne (Paris) 1997; 148:453. [PMID: 9538380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Affiliation(s)
- I Benharrats
- Service de Médecine Interne A, Hôpital Tenon, Paris
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