Volume 32, Issue 1, March 2021

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Mediterr J Rheumatol 2021;32(1):21-30
Co-Design of a Disease Activity Based Self-Management Approach for Patients with Rheumatoid Arthritis
Authors Information
1. Radboud University Medical Centre, Radboud Institute for Health Sciences, IQ Healthcare, Nijmegen, The Netherlands
2. Venray, The Netherlands
3. The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon (NH), United States of America
4. University of Twente, Department of Psychology, Health and Technology, Enschede, The Netherlands
5. Bernhoven, Department of Rheumatology, Uden, The Netherlands

M Spijk-de Jonge, AMP Huis, Glyn Elwyn, P van Riel, Marlies E. J. L. Hulscher

Objective: The systematic development of an intervention to improve disease activity-based management of rheumatoid arthritis (RA) in daily clinical practice that is based on patient-level barriers. Methods:The self-management strategy was developed through a step-wise approach, in a process of co-design with all stakeholders and by addressing patient level barriers to RA management based on disease activity. Results: The resulting DAS-pass strategy consists of decision supportive information and guidance by a specialised rheumatology nurse. It aims to increase patients’ knowledge on DAS28, to empower patients to be involved in disease management, and to improve patients’ medication beliefs. The decision supportive information includes an informational leaflet and a patient held record. The nurse individualises the information, stimulates patients to communicate about disease activity, and offers the opportunity for questions or additional support. Conclusion:The DAS-pass strategy was found helpful by stakeholders. It can be used to improve RA daily clinical practice. Our systematic approach can be used to improve patient knowledge and self-management on other RA related topics. Also, it can be used to improve the management of other chronic conditions. We therefore provide a detailed description of our methodology to assist those interested indeveloping an evidence-based strategy for educating and empowering patients.

Article Submitted: 13 Dec 2020; Article Accepted: 10 Jan 2021; Available Online: 31 Mar 2021


This work is licensed under a Creative Commons Attribution 4.0 International License (CC-BY). 

©Spijk-de Jonge MJ, Manders SHM, Huis AMP, Elwyn G, van de Laar MAFJ, van Riel PLCM, Hulscher MEJL.