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Research ArticleAccepted Articles

An environmental scan and appraisal of patient online resources for managing rheumatoid arthritis flares

Shakeel Subdar, Alison M. Hoens, Krista White, Nicole M.S. Hartfeld, Kiran Dhiman, Keeva Duffey, Claire E. Heath, Gisele Lamoureux, Christine Graveline, Eileen Davidson, Glen Hazlewood, Diane Lacaille, Elena Lopatina, Megan R.W. Barber, Karen L. Then, Trafford Crump, Saania Zafar, Sarah L. Manske, Alexandra Charlton, Kelly Osinski, Aurore Fifi-Mah, Dianne Mosher and Claire E.H. Barber
The Journal of Rheumatology March 2024, jrheum.2023-1025; DOI: https://doi.org/10.3899/jrheum.2023-1025
Shakeel Subdar
Shakeel Subdar HBSc, University of Toronto, Toronto, Ontario, Canada.
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Alison M. Hoens
Alison M. Hoens PT MSc, Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada.
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Krista White
Krista White MA, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Nicole M.S. Hartfeld
Nicole M.S. Hartfeld MSc MC, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Kiran Dhiman
Kiran Dhiman MPH, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Keeva Duffey
Keeva Duffey MPH, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Claire E. Heath
Claire E. Heath MN, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Gisele Lamoureux
Gisele Lamoureux, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Christine Graveline
Christine Graveline, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Eileen Davidson
Eileen Davidson, Arthritis Patient Advisory Board, Arthritis Research Canada, Vancouver, British Columbia, Canada.
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Glen Hazlewood
Glen Hazlewood MD PhD FRCPC, Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Diane Lacaille
Diane Lacaille MDCM MHSc FRCPC, Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Medicine, University of British Columbia, Vancouver, British Columbia.
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Elena Lopatina
Elena Lopatina MD PhD, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Alberta Health Services, Calgary, Alberta, Canada.
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Megan R.W. Barber
Megan R.W. Barber MD PhD FRCPC, Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Karen L. Then
Karen L. Then ACNP PhD, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
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Trafford Crump
Trafford Crump PhD, Department of Surgery, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
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Saania Zafar
Saania Zafar BCR MSc, Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Sarah L. Manske
Sarah L. Manske PhD, Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Alexandra Charlton
Alexandra Charlton BScPharm PharmD, Alberta Health Services, Calgary, Alberta, Canada.
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Kelly Osinski
Kelly Osinski RN BN, Alberta Health Services, Calgary, Alberta, Canada.
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Aurore Fifi-Mah
Aurore Fifi-Mah MD FRCPC, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Dianne Mosher
Dianne Mosher MD FRCPC, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Claire E.H. Barber
Claire E.H. Barber MD PhD FRCPC, Arthritis Research Canada, Vancouver, British Columbia, Canada; Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
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Abstract

Objective To conduct an environmental scan and appraisal of online patient resources to support rheumatoid arthritis (RA) flare self-management.

Methods We used the Google search engine (last search March 2023) using terms: rheumatoid arthritis and flare management. Additional searches targeted major arthritis organizations, regional, national, and international resources. Appraisal of the resources was conducted by two research team members and one patient partner to assess the understandability and actionability of the resource using the Patient Education Materials Assessment Tool (PEMAT). Resources rating ≥ 60% in both domains by either the research team, or the patient partner were further considered for content review. During content review, resources were excluded for product advertisements, inaccurate information, or use of non-inclusive language. If content review criteria were met, resources were designated as "highly recommended" if both patient partners and researchers' PEMAT ratings were ≥ 60%. If PEMAT ratings were divergent and had a rating ≥ 60% from only one group of reviewers, the resource was designated 'acceptable'.

Results We identified 44 resources and 12 were excluded as they did not pass the PEMAT assessment. Fourteen resources received ratings ≥ 60% on understandability and actionability from both researchers and patient partners, and 10 of these were retained following content review as "highly recommended" flare resources. Of the 18 divergent PEMAT ratings, 8 resources were retained as "acceptable" following content review.

Conclusion There is high variability in the actionability and understandability of RA flare materials online and only 23% of resources were highly recommended by researchers and patient partners.

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The Journal of Rheumatology
Vol. 52, Issue 6
1 Jun 2025
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Accepted manuscript
An environmental scan and appraisal of patient online resources for managing rheumatoid arthritis flares
Shakeel Subdar, Alison M. Hoens, Krista White, Nicole M.S. Hartfeld, Kiran Dhiman, Keeva Duffey, Claire E. Heath, Gisele Lamoureux, Christine Graveline, Eileen Davidson, Glen Hazlewood, Diane Lacaille, Elena Lopatina, Megan R.W. Barber, Karen L. Then, Trafford Crump, Saania Zafar, Sarah L. Manske, Alexandra Charlton, Kelly Osinski, Aurore Fifi-Mah, Dianne Mosher, Claire E.H. Barber
The Journal of Rheumatology Mar 2024, jrheum.2023-1025; DOI: 10.3899/jrheum.2023-1025

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Accepted manuscript
An environmental scan and appraisal of patient online resources for managing rheumatoid arthritis flares
Shakeel Subdar, Alison M. Hoens, Krista White, Nicole M.S. Hartfeld, Kiran Dhiman, Keeva Duffey, Claire E. Heath, Gisele Lamoureux, Christine Graveline, Eileen Davidson, Glen Hazlewood, Diane Lacaille, Elena Lopatina, Megan R.W. Barber, Karen L. Then, Trafford Crump, Saania Zafar, Sarah L. Manske, Alexandra Charlton, Kelly Osinski, Aurore Fifi-Mah, Dianne Mosher, Claire E.H. Barber
The Journal of Rheumatology Mar 2024, jrheum.2023-1025; DOI: 10.3899/jrheum.2023-1025
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