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

Kanta Kumar; Caroline Bradbury-Jones; Christopher J Armitage; Sarah Peters; Sabrina Raizada; Peter Wong

doi:10.1093/rap/rkaa009

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

Rheumatol Adv Pract. 2020 Mar 24;4(1):rkaa009. doi: 10.1093/rap/rkaa009. eCollection 2020.

Authors

Kanta Kumar¹, Caroline Bradbury-Jones¹, Christopher J Armitage^{2

3}, Sarah Peters², Sabrina Raizada⁴, Peter Wong⁵

Affiliations

¹ Insitute of Clinical Sciences, University of Birmingham, Birmingham.
² Division of Psychology and Mental Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester.
³ Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester.
⁴ Department of Rheumatology, Royal Wolverhampton Hospitals NHS Trusts, Wolverhampton, UK.
⁵ Department of Rheumatology, Westmead Hospital, Westmead, NSW, Australia.

Abstract

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

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

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

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

Keywords: Doppler ultrasound scan; ethnicity; illness perceptions; medication adherence; rheumatoid arthritis.