ANSWER-2: a decision aid on biologics for patients with rheumatoid arthritis

If symptoms of rheumatoid arthritis (RA) do not improve by taking one or more disease-modifying anti-rheumatic drugs (DMARDs), doctors may recommend a new generation drugs including biologics and small molecules’

There are a number of treatments available, each with different side effects and can be expensive. Some are taken by injection, while others can be taken as a pill. Given these considerations, some people with RA were uncertain when deciding whether to begin a therapy.

Led by Dr. Linda Li, our research team is developing ANSWER-2 for people with RA who are considering one of the biologic and other new therapies for their treatment. By featuring real-life patient stories and evidence-based information tailored to the individual, this new decision aid will help people to consider the pros and cons of biologic therapy in a meaningful way.





A prototype of ANSWER-2 has been developed, and the research team have recruited participants with RA to test it. Changes were made to ensure that it is user-friendly. Patients whose doctors have recommended a biologic are now invited to use ANSWER-2. Before and after using ANSWER-2, patients will be asked to complete an online questionnaire to give insight into their knowledge of biologics and other new therapies and their level of uncertainty in making decisions about taking this form of treatment. Patients will also provide feedback about their experience using this decision aid.

This exciting project empowers patients to discuss treatment options with their doctors and to reach informed treatment decisions. Appropriate treatment of RA also means major cost savings (over $5 billion in direct medical costs) to Canadian society.


Scientific papers published about this study include:

2014-03-17_1630_PaperEffects of a web-based patient decision aid on biologic and small-molecule agents for rheumatoid arthritis: Results from a proof-of-concept study. Li LC, Shaw CD, Lacaille D, Yacyshyn E, Jones CA, Koehn C, Hoens AM, Geldman J, Sayre EC, Macdonald GG, Leese J, Bansback N. Arthritis Care & Research. 2018;70(3):343-352.



Principal Investigator:
Linda Li

Paul Adam, Vancouver General Hospital (Knowledge User)
Sydney Brooks, The Arthritis Society (Knowledge User)
Elaine Yacyshyn, University of Alberta
Nick Bansback, University of British Columbia
Allyson Jones, University of Alberta
Diane Lacaille, Arthritis Research Centre of Canada
Chris Shaw, Simon Fraser University
Anne Townsend, University of British Columbia

The Centre for Digital Media
Alison Hoens, Knowledge Broker, Department of Physical Therapy, University of British Columbia
Pam Montie, Arthritis Research Centre’s Consumer Advisory Board
Martina Franchi, Health & Benefits Consultant & Principal at Mercer
Sheila Kerr, Arthritis Research Centre’s Consumer Advisory Board
Ruta Cummings, Arthritis Research Centre’s Consumer Advisory Board
Sharan Rai, Arthritis Research Centre’s Consumer Advisory Board
Cheryl Koehn, Arthritis Consumer Experts