None listed
Conditions
Brief summary
Medications to treat rheumatoid arthritis and psoriatic arthritis have possible side effects. People may be unwilling to take them if they are unaware of the benefits. Educational tools using pictures may improve people’s understanding of arthritis and medications. Musculoskeletal ultrasound (US) is useful in assessment of joint inflammation and damage. It is portable, non-invasive, and allows joint structures to be seen in "real-time". It may be rapidly done by a trained user. There is strong evidence that US is of value in monitoring the severity of rheumatoid arthritis and psoriatic arthritis. Recent work by our research group has shown that patients found real-time US more useful than written leaflets or online information for understanding rheumatoid arthritis and medications used to treat it. The aim of this study is to determine if showing people with rheumatoid or psoriatic arthritis “real-time” US of their inflamed joints: i) improves their willingness to take an extra medication which turns off inflammation (Disease Modifying Anti-Rheumatic Drug, or DMARD) and ii) increases their willingness to keep taking this medication (medication adherence) This research has been initiated by the study doctor, A/Prof Peter Wong. This research has been funded by investigator-initiated grants from Pfizer. The funding bodies have no input into conduct of the research.
Interventions
A 30-minute musculoskeletal ultrasound (MSK US) of clinically involved joint(s) by a rheumatologist trained in this imaging modality. During the session, participants will be shown real-time images of one or more inflamed joints. The operator will explain the anatomic landmarks (eg tendon, joint space, cartilage) and sonographic findings (eg, synovitis, erosion, effusion, doppler flow). Images will be compared to still sonographic pictures of a normal joint. The examination will take approximate
A 30-minute musculoskeletal ultrasound (MSK US) of clinically involved joint(s) by a rheumatologist trained in this imaging modality. During the session, participants will be shown real-time images of one or more inflamed joints. The operator will explain the anatomic landmarks (eg tendon, joint space, cartilage) and sonographic findings (eg, synovitis, erosion, effusion, doppler flow). Images will be compared to still sonographic pictures of a normal joint. The examination will take approximately 30 minutes on one occasion and will occur in a quiet darkened room.
Sponsors
Westmead Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Educational / counselling / training
Masking
Blinded (masking used) (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• greater than or equal to 18 year old patients with RA or PsA as per internationally accepted criteria with disease duration less than 5 years; • incompletely controlled RA or PsA (DAS 2.6-5.1) despite a csDMARD for greater than or equal to 3 months; • patient willingness to escalate immunosuppression less than or equal to 50 on anchored visual analogue scale (VAS; range 0-100), where 0 equals not willing under any circumstances and 100 equals definitely willing.
Exclusion criteria
• Extreme ill-health. • Inability to provide informed consent for study participation. • Non-English primary language • Previous MSK US
Outcome results
None listed