ANSWER DC: making decisions on rheumatoid arthritis treatment

People with rheumatoid arthritis (RA) often experience frustration when attempting to access credible information about their treatment. This may lead to poor adherence to recommended therapy.

We developed an online decision aid called the Animated Self-serve WEb-based Research (ANSWER) tool to provide evidence-based information on methotrexate and decision-support for patients. The study will address two questions:

    1. Is it feasible to implement the ANSWER with decision coaching from
      an arthritis-trained therapist?
    2. What are the benefits to patients?

We will recruit a total of 51 patients with RA in Ontario and Alberta, who have been prescribed methotrexate but have not started the treatment. They will complete the ANSWER online, and have a 20-minute structured telephone consultation with one of five arthritis therapists to clarify their personal preferences, questions and concerns. At the end of the session, the ANSWER will produce a one-page summary for patients to discuss with their doctors.

Participants will complete the Decision Conflict Scale, the Methotrexate in RA Knowledge test (MiRAK), and the Effective Consumer-17 scale (EC-17) before and immediately after the intervention, as well as one month after the intervention.

In addition, all arthritis therapists and a random sample of 10-15 patients will participate in an interview to further assess their experience in the decision coaching and the decision making processes.

The results will enable us to refine the implementation of patient decision aids in the clinical setting.

This study will contribute to building awareness of RA, improving patients’ knowledge and use of methotrexate, and expanding arthritis therapists’ consultation roles in RA.


Scientific posters presented about this network include:

2014-03-12_1019_Poster-ImageDevelopment and Usability Testing of ANSWER: A web-based methotrexate Decision Aid for Patients with Rheumatoid Arthritis. Presented at the 34th Annual Meeting of the Society for Medical Decision Making, Phoenix Arizona, October 17-20, 2012

2014-03-12_1019_Poster-ImageA Proof-of-Concept Study of ANSWER: A web-based methotrexate Decision Aid for Patients with Rheumatoid Arthritis. Presented at the American College of Rheumatology / American Health Professionals Association, Washington DC, November 9-14, 2012


Scientific papers published about this study include:

2014-03-17_1630_PaperRheumatologists’ Views and Perceived Barriers to Using Patient Decision Aids in Clinical Practice. Zong JY, Leese J, Klemm A, Sayre EC, Memetovic J, Esdaile JM, Li LC. Arthritis care & research. 2015 Oct;67(10):1463-70.

Principal Investigator:

Linda Li

Diane Lacaille
Elaine Yacyshyn
Sydney Lineker
Allyson Jones