Jasvinder A. Singh|Liana Fraenkel|Candace Green|Graciela S. Alarcón|Jennifer Barton|Kenneth G. Saag|Leslie Hanrahan|Sandra Raymond|Robert P. Kimberly|Amye Leong|Elyse Reyes|Richard L. Street|María E. Suarez?Almazor|Guy S. Eakin|Laura Marrow|Charity Morgan|Brennda Caro|Jeffrey A. Sloan|Bochra Jandali|Salvador Garcia|Jennifer M. Grossman|Kevin Winthrop|Laura Trupin|Maria Dall’Era|Alexa Meara|Tara Rizvi|W. Winn Chatham|Jinoos Yazdany
Individualized decision aid for diverse women with lupus nephritis (IDEA-WON): A randomized controlled trial
University of Alabama at Birmingham|Birmingham VA Medical Center|Yale University|University of Alabama at Birmingham|University of Alabama at Birmingham|VA Portland Health Care System|Oregon Health & Science University|University of Alabama at Birmingham|Lupus Foundation of America|Lupus Foundation of America|University of Alabama at Birmingham|Healthy Start|Texas A&M University|The University of Texas MD Anderson Cancer Center|Arthritis Foundation|Arthritis Foundation|University of Alabama at Birmingham|Georgia State University|Mayo Clinic|Baylor College of Medicine|Baylor College of Medicine|University of California, Los Angeles|Oregon Health & Science University|University of California, San Francisco|University of California, San Francisco|The Ohio State University|Baylor College of Medicine|University of Alabama at Birmingham|University of California, San Francisco
background treatment decisionmaking regarding immunosuppressive therapy challenging individuals lupus assessed effectiveness decision aid immunosuppressive therapy lupus nephritis methods findings united states multicenter openlabel randomized controlled trial rct adult women lupus nephritis mostly racialethnic minority backgrounds low socioeconomic status ses seen outpatient settings randomized individualized culturally tailored computerized decision aid versus american college rheumatology acr lupus pamphlet 11 ratio using computergenerated randomization hypothesized coprimary outcomes decisional conflict informed choice regarding immunosuppressive medications would improve decision aid group 301 randomized women 298 analyzed 47 africanamerican 26 hispanic 15 white mean age standard deviation sd 37 12 years 57 annual income 40000 36 high school education less compared provision acr lupus pamphlet n 147 participants randomized decision aid n 151 1 clinically meaningful statistically significant reduction decisional conflict 218 standard error se 25 versus 127 se 20 p 0005 2 difference informed choice main analysis 41 versus 31 p 008 clinically meaningful statistically significant difference sensitivity analysis net values immunosuppressives positive favor versus negative 50 versus 35 p 0006 unresolved decisional conflict lower decision aid versus pamphlet groups 22 versus 44 p 0001 significantly patients decision aid versus pamphlet group rated information excellent understanding lupus nephritis 49 versus 33 risk factors 43 versus 27 medication options 50 versus 33 p 0003 ease use materials higher decision aid versus pamphlet groups 51 versus 38 p 0006 key study limitations exclusion men short followup lack clinical outcomes including medication adherence conclusions individualized decision aid effective usual care reducing decisional conflict choice immunosuppressive medications women lupus nephritis trial registration clinicaltrialsgov nct02319525