Individualized decision aid for diverse women with lupus nephritis (IDEA-WON): A randomized controlled trial

Singh, Jasvinder A.; Fraenkel, Liana; Green, Candace; Alarcón, Graciela S.; Barton, Jennifer L.; Saag, Kenneth G.; Hanrahan, Leslie; Raymond, Sandra; Kimberly, Robert P.; Leong, Amye; Reyes, Elyse; Street, Richard L.; Suarez‐Almazor, María E.; Eakin, Guy S.; Marrow, Laura; Morgan, Charity; Caro, Brennda; Sloan, Jeffrey A.; Jandali, Bochra; Garcia, Salvador; Grossman, Jennifer M.; Winthrop, Kevin; Trupin, Laura; Dall’Era, Maria; Meara, Alexa; Rizvi, Tara; Chatham, W. Winn; Yazdany, Jinoos

doi:10.1371/journal.pmed.1002800

Cited by 29 publications

(25 citation statements)

References 55 publications

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“…Community‐based deprivation indicators such as premature death, quality of life, crime, location to amenities, housing quality, air quality and community status on road traffic accident were not reported in any trial. One trial (0.3%; Singh et al, 2019) presented subgroup results by social deprivation measures.…”

Section: Resultsmentioning

confidence: 99%

Reporting of social deprivation in musculoskeletal trials: An analysis of 402 randomised controlled trials

Smith

Kamper

Williams

et al. 2020

Musculoskeletal Care

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Background Social deprivation is broadly defined as the restriction of access an individual has to social or cultural interactions due to poverty, discrimination or other disadvantages. While social deprivation is a widely acknowledged determinant of outcome in musculoskeletal conditions, it remains unclear how this is considered in the conduct and interpretation of musculoskeletal trials. Aim To determine the frequently to which measures of social deprivation are reported in trials recruiting people with musculoskeletal diseases. Materials and Methods We conducted a Pubmed search of randomised controlled trials published between 01 January 2019 and 01 June 2020. We included full‐text papers of trials recruiting people with musculoskeletal diseases, irrespective of intervention type or origin. We extracted data relating to trial characteristics, setting, trial design, funding source and musculoskeletal disease. We extracted data on any reported social deprivation index or measure of social deprivation based on internationally adopted indicators. We analysed data descriptively to summarise the reporting of each social deprivation index and measure of social deprivation within trials. Results From 2133 potentially eligible citations, 402 were eligible. Mean age of participants was 51.7 years; 63% were female. Trials most frequently recruited people with spinal pain (24.6%) or osteoarthritis (10.0%). Two trials (0.5%) reported social deprivation indices/scores. When assessed by discrete measures of social deprivation, 164 trials (40.8%) reported one or more social deprivation measures. The most commonly reported measures were morbidity (20.2%), employment status (17.7%) and educational attainment (15.5%). Race (6.7%), ethnicity (6.2%) and annual salary (1.3%) were infrequently reported. One trial (0.3%) presented subgroup results by social deprivation measures. Discussion and Conclusion Social deprivation is inconsistently reported in musculoskeletal trials. Trialists should report baseline measures of social deprivation in trial reports and aid generalisability to target population, and to examine whether social deprivation might modify treatment effects of interventions for musculoskeletal conditions.

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Section: Resultsmentioning

confidence: 99%

Reporting of social deprivation in musculoskeletal trials: An analysis of 402 randomised controlled trials

Smith

Kamper

Williams

et al. 2020

Musculoskeletal Care

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“…The intervention did not increase visit time, improved medication adherence, and decreased disease activity among African American and Hispanic patients. Patient-facing materials such as low-literacy information guides and decision-making materials have been implemented to improve patient-physician communication and shared decisionmaking (32)(33)(34); these are likely to address gaps in communication and understanding due to limited health literacy as well.…”

Section: Discussionmentioning

confidence: 99%

Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

Katz

Dall’Era

Trupin

et al. 2020

Arthritis Care & Research

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Objective. Health disparities in patient-reported outcomes by income and education are well documented; however, the impact of health literacy on patient-reported outcomes has received less attention. We examined independent effects of income, education, and health literacy on patient-reported outcomes in systemic lupus erythematosus (SLE). Methods. Data from the California Lupus Epidemiology Study (n = 323 participants) were used. Health literacy was assessed with a validated 3-item measure (ability to understand written information, reliance on others to understand written information, confidence in completing written forms). Patient-reported outcomes were administered by interview in English, Spanish, Cantonese, or Mandarin. Generic and disease-specific patient-reported outcomes were examined using the following: 10 Patient-Reported Outcomes Measurement Information System (PROMIS) short forms; the 8 Short Form 36 (SF-36) health survey subscales; and 3 patient-reported SLE disease activity and damage measures. We conducted 2 sets of multivariable analyses: the first examined education, income, or health literacy individually; the second included all 3 simultaneously. All multivariable models included age, sex, race/ ethnicity, language, disease duration, and physician-assessed disease activity and damage. Results. More than one-third of participants (38%) had limited health literacy (LHL), including >25% with greater than high school education. In multivariable analyses simultaneously considering education, income, and health literacy, LHL was associated with significantly worse scores on all patient-reported outcomes except disease damage. In contrast, disparities by income were seen in only 3 PROMIS scales, 3 SF-36 subscales, and 1 disease activity measure. No disparities by education level were noted. Conclusion. We found significantly worse patient-reported outcome scores among individuals with LHL, even after controlling for disease activity and damage. Whether disparities are due to actual differences in health or measurement issues requires further study.

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“…36–60 An additional 13 studies of SDM interventions were included in the secondary analysis (Figure 1). 61–73…”

Section: Resultsmentioning

confidence: 99%

“…42,56 When including other SDM intervention studies, results remained significant, favoring the interventions (Supplemental File 2, Figure 7). 63,65,67,69,71,73…”

Section: Resultsmentioning

confidence: 99%

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A Systematic Review and Meta-Analysis of Patient Decision Aids for Socially Disadvantaged Populations: Update from the International Patient Decision Aid Standards (IPDAS)

et al. 2021

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Background The effectiveness of patient decision aids (PtDAs) and other shared decision-making (SDM) interventions for socially disadvantaged populations has not been well studied. Purpose To assess whether PtDAs and other SDM interventions improve outcomes or decrease health inequalities among socially disadvantaged populations and determine the critical features of successful interventions. Data Sources MEDLINE, CINAHL, Cochrane, PsycINFO, and Web of Science from inception to October 2019. Cochrane systematic reviews on PtDAs. Study Selection Randomized controlled trials of PtDAs and SDM interventions that included socially disadvantaged populations. Data Extraction Independent double data extraction using a standardized form and the Template for Intervention Description and Replication checklist. Data Synthesis Twenty-five PtDA and 13 other SDM intervention trials met our inclusion criteria. Compared with usual care, PtDAs improved knowledge (mean difference = 13.91, 95% confidence interval [CI] 9.01, 18.82 [I2 = 96%]) and patient-clinician communication (relative risk = 1.62, 95% CI 1.42, 1.84 [I2 = 0%]). PtDAs reduced decisional conflict (mean difference = −9.59; 95% CI −18.94, −0.24 [I2 = 84%]) and the proportion undecided (relative risk = 0.39; 95% CI 0.28, 0.53 [I2 = 75%]). PtDAs did not affect anxiety (standardized mean difference = 0.02, 95% CI −0.22, 0.26 [I2 = 70%]). Only 1 trial looked at clinical outcomes (hemoglobin A1C). Five of the 12 PtDA studies that compared outcomes by disadvantaged standing found that outcomes improved more for socially disadvantaged participants. No evidence indicated which intervention characteristics were most effective. Results were similar for SDM intervention trials. Limitations Sixteen PtDA studies had an overall unclear risk of bias. Heterogeneity was high for most outcomes. Most studies only had short-term follow-up. Conclusions PtDAs led to better outcomes among socially disadvantaged populations but did not reduce health inequalities. We could not determine which intervention features were most effective. [Box: see text]

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Individualized decision aid for diverse women with lupus nephritis (IDEA-WON): A randomized controlled trial

Cited by 29 publications

References 55 publications

Reporting of social deprivation in musculoskeletal trials: An analysis of 402 randomised controlled trials

Reporting of social deprivation in musculoskeletal trials: An analysis of 402 randomised controlled trials

Impact of Limited Health Literacy on Patient‐Reported Outcomes in Systemic Lupus Erythematosus

A Systematic Review and Meta-Analysis of Patient Decision Aids for Socially Disadvantaged Populations: Update from the International Patient Decision Aid Standards (IPDAS)

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