Barriers & facilitators to effective disease-management in RA.
Research type
Research Study
Full title
Understanding barriers and facilitators to effective disease-management in Rheumatoid Arthritis to prevent refractory disease. A Mixed-Methods study with a focus on social determinants of treatment outcomes.
IRAS ID
300577
Contact name
Elena Nikiphorou
Contact email
Sponsor organisation
King's College London
Duration of Study in the UK
1 years, 2 months, 4 days
Research summary
There is a pressing need to understand the social dimensions that add to disease burden in rheumatoid arthritis (RA) and potential synergistic interactions with biological parameters of disease, such as level of inflammation. In particular, understanding the key drivers of refractory RA, right from disease onset can lead to a better paradigm for developing interventions to strengthen the role and impact of ill-health prevention and improve patient experience and outcomes. This is of utmost importance and necessary for preventing health inequalities.\n \nThe main goal of this 14-month study is to identify the most relevant social determinants of treatment outcomes in RA through an exploration of the complex (social) processes of barriers and facilitators to optimal care and successful treatment. This will be achieved through two patient focus groups, with approximately 10 participants in each, and 16 – 20 patient interviews. \n Recruitment will be targeted at patients over the age of 16 with refractory RA, defined in this study by a moderate/high disease activity score in 28 joints on at least two consecutive occasions, within the first year in patients with early RA (12 months disease duration) or after the first year in patients with established RA (over 12 months disease duration) allowing for comparisons to be made. These patients will be identified from the King’s College Hospital (KCH) electronic database. The intention will be to target those people with relevant social factors that may be implicated in treatment failure.\n \nThis study will provide a unique opportunity for an in-depth understanding of the impact of social determinants in RA and barriers and challenges to implementation of effective disease-management to minimise the risk of treatment failure and therefore refractory disease. The study is to be co-sponsored by King’s College London (KCL) and King’s College Hospital NHS Foundation Trust (KCH). \n\n
REC name
North of Scotland Research Ethics Committee 1
REC reference
22/NS/0012
Date of REC Opinion
19 Jan 2022
REC opinion
Favourable Opinion