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Research ArticleArticle

Patient Empowerment Among Adults With Arthritis: The Case for Emotional Support

Kathleen L. Carluzzo, Erin M. Knight, Karen E. Schifferdecker, Rebecca L. Butcher, Guy S. Eakin, Julie A. Eller and Jasvinder A. Singh
The Journal of Rheumatology February 2022, jrheum.210818; DOI: https://doi.org/10.3899/jrheum.210818
Kathleen L. Carluzzo
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Erin M. Knight
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Karen E. Schifferdecker
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Rebecca L. Butcher
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Guy S. Eakin
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Julie A. Eller
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Jasvinder A. Singh
This work was supported through a contract with the Arthritis Foundation. K.L. Carluzzo, MS, Senior Research Associate, E.M. Knight, PhD, Senior Research Associate, R.L. Butcher MS, MPH, Senior Research Scientist and Associate Director, Center for Program Design and Evaluation, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; K.E. Schifferdecker, PhD, MPH, Director of Center for Program Design and Evaluation and Associate Professor, Geisel School of Medicine, Dartmouth College, Hanover, New Hampshire; G.S. Eakin, Senior Vice President of Scientific Strategy, J.A. Eller, Director, Patient Centered Strategies, Arthritis Foundation, Atlanta, Georgia; J.A. Singh, MBBS, MPH, Physician, Medicine Service, Birmingham VA Medical Center, and Professor of Medicine and Epidemiology at the Schools of Medicine and Public Health at University of Alabama at Birmingham, Birmingham, Alabama, USA. JAS has received consultant fees from Crealta/Horizon, Medisys, Fidia, PK Med, Two Labs Inc., Adept Field Solutions, Clinical Care Options, Clearview Healthcare Partners, Putnam Associates, Focus Forward, Navigant Consulting, Spherix, MedIQ, Jupiter Life Science, UBM LLC, Trio Health, Medscape, WebMD, and Practice Point Communications; and the National Institutes of Health and the American College of Rheumatology. JAS has received institutional research support from Zimmer Biomet Holdings. JAS owns stock options in TPT Global Tech, Vaxart Pharmaceuticals, Atyu Biopharma, Adaptimmune Therapeutics, GeoVax Labs, Pieris Pharmaceuticals, Enzolytics, Seres Therapeutics, Tonix Pharmaceuticals, and Charlotte's Web Holdings. JAS is a member of the executive committee of Outcome Measures in Rheumatology Trials (OMERACT), an organization that receives arms-length funding from 12 companies. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to K. Carluzzo, Williamson Building #537, One Medical Center Drive, Lebanon, NH 03756, USA. Email: kathleen.l.carluzzo@dartmouth.edu. Accepted for publication January 14, 2022.
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Abstract

Objective This study aimed to identify differences in patient empowerment based on biopsychosocial patient-reported measures, the magnitude of those differences, and which measures best explain differences in patient empowerment.

Methods This was a cross-sectional observational study of 6918 adults with arthritis in the US. Data were collected from March 2019 to March 2020 through the Arthritis Foundation Live Yes! INSIGHTS program. Patient empowerment, measured by the Health Care Empowerment Questionnaire, included 2 scales: Patient Information Seeking and Healthcare Interaction Results. Patient-reported outcomes were measured using the Patient Reported Outcomes Measurement Information System (PROMIS)-29 and PROMIS emotional support scale. ANOVA assessed differences between groups, and Spearman rank correlation assessed correlations between variables. Hierarchical regression analysis determined the contributions of sociodemographic characteristics, arthritis type, and patent-reported health measures in explaining patient empowerment (α = 0.05).

Results Empowerment was lower among those who were male, older, less educated, or who had lower income, osteoarthritis, less emotional support, or better physical function, although the effect was small-to-negligible for most of these variables in the final regression models. Empowerment did not differ by race/ethnicity in unadjusted or adjusted analysis. In final regression models, emotional support contributed the most to explaining patient empowerment.

Conclusion Emotional support is important for patient empowerment. This suggests that programs that seek to improve patient empowerment should target and measure effects on emotional support.

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Patient Empowerment Among Adults With Arthritis: The Case for Emotional Support
Kathleen L. Carluzzo, Erin M. Knight, Karen E. Schifferdecker, Rebecca L. Butcher, Guy S. Eakin, Julie A. Eller, Jasvinder A. Singh
The Journal of Rheumatology Feb 2022, jrheum.210818; DOI: 10.3899/jrheum.210818

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Patient Empowerment Among Adults With Arthritis: The Case for Emotional Support
Kathleen L. Carluzzo, Erin M. Knight, Karen E. Schifferdecker, Rebecca L. Butcher, Guy S. Eakin, Julie A. Eller, Jasvinder A. Singh
The Journal of Rheumatology Feb 2022, jrheum.210818; DOI: 10.3899/jrheum.210818
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