Skip to main content

Advertisement

Log in

Educational website incorporating rheumatoid arthritis patient needs for Latin American and Caribbean countries

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

Health education is fundamental in the management of RA patients. This study explored patient needs for educational material appropriate for RA patients in our region through a website. This study includes seven focus groups and semi-structured interviews across 4 countries (Argentina, Chile, Colombia, and Mexico) with 71 RA patients. Transcripts were analyzed by anthropologists using qualitative analysis (QA), resulting in themes and subthemes to be developed. Five themes and over 50 subthemes of interest were identified by patients. Grouped into categories as follows: (1) knowing the disease, (2) living with arthritis, (3) treatment and therapies for RA, (4) psychosocial support, and (5) information for families. A response was written by the team in plain Spanish on patient subthemes of interest including additional areas that the team considered relevant. Three videos for YouTube were produced: on patient-doctor relationships, patients at work, and home and at the clinic. Illustrations in a comic book format on RA diagnosis were created. The educational site on RA of PANLAR can be found at htpp://artritisreumatoide.cl. This project accomplished a comprehensive list of RA patient interests, revealing the complex relationship between the information on the disease, the experience of a chronic disease, and the way in which patients approach, conceive, and manage their disease. We expect to gather information on how the website will be used in the future for patients and their families and maintain and improve the website as well as adapt its content to different socioeconomic realities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Pelaez-Ballestas I, Sanin LH, Moreno-Montoya J, Alvarez-Nemegyei J, Burgos-Vargas R, Garza-Elizondo M, Rodriguez-Amado J, Goycochea-Robles MV, Madariaga M, Zamudio J, Santana N, Cardiel MH (2011) Grupo de Estudio Epidemiologico de Enfermedades Musculo A. Epidemiology of the rheumatic diseases in Mexico A study of 5 regions based on the COPCORD methodology J Rheumatol Suppl 86:3–8. https://doi.org/10.3899/jrheum.100951

    PubMed  Google Scholar 

  2. Cardiel MH (2011) Present and future of rheumatic diseases in Latin America. Are we prepared to face them? Reumatol Clin 7(5):279–280. https://doi.org/10.1016/j.reuma.2010.12.009

    Article  PubMed  Google Scholar 

  3. Cardiel MH, Burgos-Vargas R (2011) Towards elucidation of the epidemiology of the rheumatic diseases in Mexico. COPCORD studies in the community. J Rheumatol Suppl 86:1–2. https://doi.org/10.3899/jrheum.100950

    Article  PubMed  Google Scholar 

  4. Massardo L, Suarez-Almazor ME, Cardiel MH, Nava A, Levy RA, Laurindo I, Soriano ER, Acevedo-Vazquez E, Millan A, Pineda-Villasenor C, Galarza-Maldonado C, Caballero-Uribe CV, Espinosa-Morales R, Pons-Estel BA (2009) Management of patients with rheumatoid arthritis in Latin America: a consensus position paper from Pan-American League of Associations of Rheumatology and Grupo Latino Americano De Estudio De Artritis Reumatoide. J Clin Rheumatol 15(4):203–210. https://doi.org/10.1097/RHU.0b013e3181a90cd8

    Article  PubMed  Google Scholar 

  5. Pincus T, Callahan LF, Sale WG, Brooks AL, Payne LE, Vaughn WK (1984) Severe functional declines, work disability, and increased mortality in seventy-five rheumatoid arthritis patients studied over nine years. Arthritis Rheum 27(8):864–872

    Article  CAS  PubMed  Google Scholar 

  6. Solomon DH, Karlson EW, Rimm EB, Cannuscio CC, Mandl LA, Manson JE, Stampfer MJ, Curhan GC (2003) Cardiovascular morbidity and mortality in women diagnosed with rheumatoid arthritis. Circulation 107(9):1303–1307

    Article  PubMed  Google Scholar 

  7. Salaffi F, Sarzi-Puttini P, Girolimetti R, Atzeni F, Gasparini S, Grassi W (2009) Health-related quality of life in fibromyalgia patients: a comparison with rheumatoid arthritis patients and the general population using the SF-36 health survey. Clin Exp Rheumatol 27(5 Suppl 56):S67–S74

    CAS  PubMed  Google Scholar 

  8. Smolen JS, Aletaha D, McInnes IB (2016) Rheumatoid arthritis. Lancet 388(10055):2023–2038. https://doi.org/10.1016/S0140-6736(16)30173-8

    Article  CAS  PubMed  Google Scholar 

  9. Contreras-Yanez I, Pascual-Ramos V (2015) Window of opportunity to achieve major outcomes in early rheumatoid arthritis patients: how persistence with therapy matters. Arthritis Res Ther 17:177. https://doi.org/10.1186/s13075-015-0697-z

    Article  PubMed  PubMed Central  Google Scholar 

  10. Paterick TE, Patel N, Tajik AJ, Chandrasekaran K (2017) Improving health outcomes through patient education and partnerships with patients. Proc (Bayl Univ Med Cent) 30(1):112–113

    Google Scholar 

  11. Zangi HA, Ndosi M, Adams J, Andersen L, Bode C, Bostrom C, van Eijk-Hustings Y, Gossec L, Korandova J, Mendes G, Niedermann K, Primdahl J, Stoffer M, Voshaar M, van Tubergen A, European League Against R (2015) EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis 74(6):954–962. https://doi.org/10.1136/annrheumdis-2014-206807

    Article  CAS  PubMed  Google Scholar 

  12. Khoury V, Kourilovitch M, Massardo L (2015) Education for patients with rheumatoid arthritis in Latin America and the Caribbean. Clin Rheumatol 34(Suppl 1):S45–S49. https://doi.org/10.1007/s10067-015-3014-y

    Article  PubMed  Google Scholar 

  13. Cardiel MH, Pons-Estel BA, Sacnun MP, Wojdyla D, Saurit V, Marcos JC, Pinto MR, Cordeiro de Azevedo AB, da Silveira IG, Radominski SC, Ximenes AC, Massardo L, Ballesteros F, Rojas-Villarraga A, Onate RV, Hernandez MP, Esquivel-Valerio JA, Garcia-De La Torre I, Khoury VJ, Millan A, Soriano ER, Gladar (2012) Treatment of early rheumatoid arthritis in a multinational inception cohort of Latin American patients: the GLADAR experience J Clin Rheumatol 18 (7):327–335. doi:https://doi.org/10.1097/RHU.0b013e31826d6610

  14. Smolen JS, Landewe R, Breedveld FC, Buch M, Burmester G, Dougados M, Emery P, Gaujoux-Viala C, Gossec L, Nam J, Ramiro S, Winthrop K, de Wit M, Aletaha D, Betteridge N, Bijlsma JW, Boers M, Buttgereit F, Combe B, Cutolo M, Damjanov N, Hazes JM, Kouloumas M, Kvien TK, Mariette X, Pavelka K, van Riel PL, Rubbert-Roth A, Scholte-Voshaar M, Scott DL, Sokka-Isler T, Wong JB, van der Heijde D (2014) EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 73(3):492–509. https://doi.org/10.1136/annrheumdis-2013-204573

    Article  CAS  PubMed  Google Scholar 

  15. Singh JA, Saag KG, Bridges SL, Jr., Akl EA, Bannuru RR, Sullivan MC, Vaysbrot E, McNaughton C, Osani M, Shmerling RH, Curtis JR, Furst DE, Parks D, Kavanaugh A, O'Dell J, King C, Leong A, Matteson EL, Schousboe JT, Drevlow B, Ginsberg S, Grober J, St Clair EW, Tindall E, Miller AS, McAlindon T, American College of R (2016) 2015 American College of Rheumatology Guideline for the Treatment of Rheumatoid Arthritis. Arthritis Care Res (Hoboken) 68 (1):1–25. doi:https://doi.org/10.1002/acr.22783

  16. Rabiee F (2004) Focus-group interview and data analysis. Proc Nutr Soc 63(4):655–660

    Article  PubMed  Google Scholar 

  17. Rees S, Williams A (2009) Promoting and supporting self-management for adults living in the community with physical chronic illness: a systematic review of the effectiveness and meaningfulness of the patient-practitioner encounter. JBI Libr. Syst Rev 7(13):492–582

    Google Scholar 

  18. Strom A, Fagermoen MS (2014) User involvement as sharing knowledge—an extended perspective in patient education. J Multidiscip Healthc 7:551–559. https://doi.org/10.2147/JMDH.S73343

    Article  PubMed  PubMed Central  Google Scholar 

  19. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, Healey LA, Kaplan SR, Liang MH, Luthra HS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324

    Article  CAS  PubMed  Google Scholar 

  20. Hewlett S, Sanderson T, May J, Alten R, Bingham CO, 3rd, Cross M, March L, Pohl C, Woodworth T, Bartlett SJ (2012) 'I'm hurting, I want to kill myself': rheumatoid arthritis flare is more than a high joint count—an international patient perspective on flare where medical help is sought. Rheumatology (Oxford) 51 (1):69–76. doi:https://doi.org/10.1093/rheumatology/keq455

  21. Alvarez ML, Muzzo S, Ivanovic D (1985) Scale for measurement of socioeconomic level, in the health area. Rev Med Chil 113(3):243–249

    CAS  PubMed  Google Scholar 

  22. Kennedy TJ, Lingard LA (2006) Making sense of grounded theory in medical education. Med Educ 40(2):101–108. https://doi.org/10.1111/j.1365-2929.2005.02378.x

    Article  PubMed  Google Scholar 

  23. Cuesta Benjumea Cdl La teoría fundamentada como herramienta de análisis. doi:10.14198/cuid.2006.20.19

  24. Lincoln IS, De la Cuesta BC (1997) Conexiones afines entre los métodos cualitativos y la investigación en salud. Investigación y Educación en enfermería 15(2):57–69

    Google Scholar 

  25. Williams IC (2012) Graphic medicine: comics as medical narrative. Med Humanit 38(1):21–27. https://doi.org/10.1136/medhum-2011-010093

    Article  PubMed  Google Scholar 

  26. Bury M (1982) Chronic illness as biographical disruption. Sociology of Health and Illness 1:167–182. https://doi.org/10.1111/11467-9566.ep11339939

    Article  Google Scholar 

  27. Kostova Z, Caiata-Zufferey M, Schulz PJ (2014) The process of acceptance among rheumatoid arthritis patients in Switzerland: a qualitative study. Pain Res Manag 19(2):61–68

    Article  PubMed  PubMed Central  Google Scholar 

  28. Martin RW (2012) Communicating the risk of side effects to rheumatic patients. Rheum Dis Clin N Am 38(4):653–662. https://doi.org/10.1016/j.rdc.2012.08.007

    Article  Google Scholar 

  29. Martin LR, Williams SL, Haskard KB, Dimatteo MR (2005) The challenge of patient adherence. Ther Clin Risk Manag 1(3):189–199

    PubMed  PubMed Central  Google Scholar 

  30. Smolen JS, Breedveld FC, Burmester GR, Bykerk V, Dougados M, Emery P, Kvien TK, Navarro-Compan MV, Oliver S, Schoels M, Scholte-Voshaar M, Stamm T, Stoffer M, Takeuchi T, Aletaha D, Andreu JL, Aringer M, Bergman M, Betteridge N, Bijlsma H, Burkhardt H, Cardiel M, Combe B, Durez P, Fonseca JE, Gibofsky A, Gomez-Reino JJ, Graninger W, Hannonen P, Haraoui B, Kouloumas M, Landewe R, Martin-Mola E, Nash P, Ostergaard M, Ostor A, Richards P, Sokka-Isler T, Thorne C, Tzioufas AG, van Vollenhoven R, de Wit M, van der Heijde D (2015) Treating rheumatoid arthritis to target: 2014 update of the recommendations of an international task force. Ann Rheum Dis. https://doi.org/10.1136/annrheumdis-2015-207524

  31. Tedeschi SK, Frits M, Cui J, Zhang ZZ, Mahmoud T, Iannaccone C, Lin TC, Yoshida K, Weinblatt ME, Shadick NA, Solomon DH (2017) Diet and rheumatoid arthritis symptoms: survey results from a rheumatoid arthritis registry. Arthritis Care Res (Hoboken). https://doi.org/10.1002/acr.23225

  32. Whitehead L, Jacob E, Towell A, Abu-Qamar M, Cole-Heath A (2017) The role of the family in supporting the self-management of chronic conditions: a qualitative systematic review. J Clin Nurs. https://doi.org/10.1111/jocn.13775

  33. Morris KJ (2013) Chronic pain in phenomenological/anthropological perspective. In: Jensen RT, Moran D (eds) The Phenomenology of Embodied Subjectivity. Springer International Publishing, Cham, pp 167–184. https://doi.org/10.1007/978-3-319-01616-0_9

    Chapter  Google Scholar 

  34. Simons G, Belcher J, Morton C, Kumar K, Falahee M, Mallen CD, Stack RJ, Raza K (2017) Symptom recognition and perceived urgency of help-seeking for rheumatoid arthritis and other diseases in the general public: a mixed method approach. Arthritis Care Res (Hoboken) 69(5):633–641. https://doi.org/10.1002/acr.22979

    Article  Google Scholar 

  35. Massardo L, Pons-Estel BA, Wojdyla D, Cardiel MH, Galarza-Maldonado CM, Sacnun MP, Soriano ER, Laurindo IM, Acevedo-Vasquez EM, Caballero-Uribe CV, Padilla O, Guibert-Toledano ZM, da Mota LM, Montufar RA, Lino-Perez L, Diaz-Coto JF, Achurra-Castillo AF, Hernandez JA, Esteva-Spinetti MH, Ramirez LA, Pineda C, Furst DE (2012) Early rheumatoid arthritis in Latin America: low socioeconomic status related to high disease activity at baseline. Arthritis Care Res (Hoboken) 64(8):1135–1143. https://doi.org/10.1002/acr.21680

    Google Scholar 

  36. Eysenbach G, Jadad AR (2001) Evidence-based patient choice and consumer health informatics in the Internet age. J Med Internet Res 3(2):E19. https://doi.org/10.2196/jmir.3.2.e19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Baker DW, Parker RM, Williams MV, Clark WS, Nurss J (1997) The relationship of patient reading ability to self-reported health and use of health services. Am J Public Health 87(6):1027–1030

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We would like to thank all the patients and collaborators (Appendix C) who helped to develop this website, the International League of Associations for Rheumatology (ILAR) for the grant to the project Web-based educational program for patients with rheumatoid arthritis in Latin America and the Caribbean countries, to Liga Panamericana de Asociaciones de Reumatología (PANLAR), and to Ms. Teresa Cole for the English version of this manuscript. With support from CONICYT grant PFB12/2007 awarded to Center for Aging and Regeneration (CARE), Facultad de Ciencias Biológicas. Pontificia Universidad Católica de Chile.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Loreto Massardo.

Ethics declarations

Disclosures

None.

Electronic supplementary material

ESM 1

(DOCX 23 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Massone, F., Martínez, M.E., Pascual-Ramos, V. et al. Educational website incorporating rheumatoid arthritis patient needs for Latin American and Caribbean countries. Clin Rheumatol 36, 2789–2797 (2017). https://doi.org/10.1007/s10067-017-3866-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-017-3866-4

Keywords

Navigation