Center to Improve Veteran Involvement in Care (CIVIC)
Developing a Tool to Facilitate Clear Communication Between Clinicians and Patients with RA
Written by Arielle Hughes
Treatment outcomes for those with chronic health conditions, such as diabetes and rheumatoid arthritis, can be improved through clear communication about treatment goals between patients and clinicians. Barriers to clear communication include clinician burnout or high caseload, lack of resources for patients (i.e., referrals for mental health services), difference in agendas between patient and clinicians, and time constraints. CIVIC Core Investigator and Rheumatology Section Chief at VA Portland Health Care System, Dr. Jennifer Barton, Rachel Matsumoto, MS, Dr. Julie Kahler, Dr. Ginnifer Mastarone, and Jacob Dougherty developed a tool to help elicit goals by facilitating clear communication between patients with rheumatoid arthritis and their clinicians.
In this study, Dr. Barton and colleagues used clinician feedback, interviews with patients with rheumatoid arthritis, and input from community stakeholders to develop a goal elicitation tool. Goal elicitation is when clinicians ask patients what their goals are for their treatment. The goal elicitation tool incorporated seven patient goals for rheumatoid arthritis treatment which were identified through a prior systematic review and focus groups with patients and clinicians. These seven goals revolved around reducing pain, work, daily activities, side effects, sleep, tiredness, and mood .
Dr. Barton and colleagues sought to make the tool easy to use and accessible to persons across the literacy spectrum, as well as patients beyond those with rheumatoid arthritis. Patients in the study reported they were able to easily use and interpret the goal elicitation tool. The tool allowed patients to better advocate for their personal treatment goals and communicate their goals more efficiently to their clinicians. Clinicians often are under time constraints and have their own agenda. Utilizing this tool helped combat this barrier by providing more structure to clinician-patient interactions and increasing efficiency.
Shared decision making involves patients playing a more active role in their treatment plan and clinicians communicating the different options available to patients for their treatment. Eliciting patient goals will enable clinicians to work with them to develop the best treatment plan that incorporates patient preferences and thereby improving adherence to treatment plans.
Dr. Jennifer Barton stated “the study highlights that it is essential to create interventions with inputs from patients as well as clinicians as a tool must be acceptable and easy to use. Even without a tool, I would recommend that clinicians always open a conversation with a patient by asking what is on their mind that day, what is their goal for the visit”. Fostering this kind of open communication could result in improved treatment outcomes for those with chronic conditions like rheumatoid arthritis.
