Supportive Care for Arthritis

(RAISE Trial)

CH
RS
Overseen ByRebecca Summit
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: Brigham and Women's Hospital
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how different support systems can help people with inflammatory arthritis manage their care more effectively. It tests three approaches: providing a list of helpful resources, support from a Community Resource Specialist familiar with local services, and guidance from a Nurse Navigator trained in rheumatic conditions. The goal is to determine which method reduces missed appointments and improves cost-effectiveness. The trial seeks participants with arthritis who have previously missed appointments and have needs related to social factors like housing or access to food. Participants must receive care at specific hospitals in the Boston area. As an unphased trial, this study offers a unique opportunity to contribute to research that could enhance support systems for arthritis care.

Do I need to stop my current medications for this trial?

The trial information does not specify whether you need to stop taking your current medications. It seems focused on providing support and resources rather than changing medical treatments.

Is there any evidence suggesting that this trial's interventions are likely to be safe?

Research has shown that community resource specialists (CRS) and nurse navigators in healthcare are generally well-received. These roles assist patients by linking them to necessary resources and organizing their care. Studies have found that when nurses teach patients, it can enhance patient safety skills, especially for those with conditions like arthritis. This suggests that trained healthcare workers, such as nurse navigators, typically do not cause negative effects.

Community resource specialists might lack formal medical training, but they possess extensive knowledge of local services and help individuals manage their healthcare needs. Although less information exists about the safety of CRS specifically, their role involves providing guidance and resources, which does not entail physical risks.

Both roles aim to improve healthcare without introducing new medical treatments, so they are generally considered safe. The primary goal is to offer support and improve access to care, not to provide treatments with physical side effects.12345

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to explore new ways to support individuals with arthritis beyond the usual medications and physical therapies. Arm 2 introduces a community resource specialist, someone with deep-rooted community knowledge but no formal medical training, offering a fresh perspective on patient support. Arm 3 features a bilingual nurse patient navigator who is not only skilled in nursing but also has specialized rheumatology training, providing more personalized care, especially for Spanish-speaking patients. These approaches could enhance patient understanding and management of arthritis in ways that traditional resource sheets and standard care might not achieve.

What evidence suggests that this trial's treatments could be effective for arthritis?

This trial will compare different supportive care approaches for arthritis. Participants in Arm 2 will receive assistance from community resource specialists, who have shown in past studies to help arthritis patients improve work attendance and manage their condition. Arm 3 participants will receive guidance from a bilingual nurse patient navigator, which studies indicate can enhance quality of life and reduce missed or canceled appointments. Both methods aim to support patients by connecting them with important resources and coordinated care. Arm 1 will serve as the control arm, receiving standard resource sheets.678910

Who Is on the Research Team?

CH

Candace H Feldman, MD, ScD

Principal Investigator

Brigham and Women's Hospital

Are You a Good Fit for This Trial?

This trial is for adults over 18 with arthritis-related rheumatic conditions who missed at least one clinic visit in the past year and have social needs, except unemployment or education. They must be getting care at specific hospitals, speak English or Spanish, and not be enrolled in certain other care programs.

Inclusion Criteria

1+ social determinants of health needs on Mass General Brigham questionnaire (excluding unemployment and education)
Receiving rheumatology care at a Brigham and Women's Hospital or Faulkner Hospital affiliated clinic
1+ prior no-show(s) or same day cancellation(s) to an ambulatory care provider in the past year
See 1 more

Exclusion Criteria

Patients already actively enrolled in an integrated care management program through their primary care provider
Medical complexity that requires urgent nursing involvement and thus not medically appropriate for randomization
Incarcerated individuals
See 1 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Intervention

Participants are assigned to one of three arms to address SDoH-related needs: Arm 1 receives standard care resource sheets, Arm 2 receives assistance from a community resource specialist, and Arm 3 receives assistance from a nurse patient navigator.

6 months
Minimum of 2 interactions per month

Adaptive Intervention

Participants who do not respond to their initial arm are reassigned to a more intensive intervention for another 6 months.

6 months

Follow-up

Participants are monitored for outcomes such as appointment adherence and SDoH-related needs resolution.

12 months

What Are the Treatments Tested in This Trial?

Interventions

  • Community Resource Specialist
  • Nurse Navigator
  • Resource sheets
  • Rheumatology-based Adaptive Intervention for Social Determinants and Health Equity
Trial Overview The study tests three support strategies for patients with systemic rheumatic conditions: a tailored resource list (Arm 1), help from a community specialist (Arm 2), and assistance from a nurse navigator trained in these conditions working with the community specialist (Arm 3).
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: Arm 3Experimental Treatment1 Intervention
Group II: Arm 2Experimental Treatment1 Intervention
Group III: Arm 1Experimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Brigham and Women's Hospital

Lead Sponsor

Trials
1,694
Recruited
14,790,000+

Bristol-Myers Squibb Foundation

Collaborator

Trials
6
Recruited
1,300+

Bristol-Myers Squibb

Industry Sponsor

Trials
2,731
Recruited
4,127,000+
Headquarters
New York City, USA
Known For
Oncology & Cardiovascular
Top Products
Eliquis, Opdivo, Revlimid, Orencia
Christopher Boerner profile image

Christopher Boerner

Bristol-Myers Squibb

Chief Executive Officer since 2023

PhD in Business Administration from the Haas School of Business, University of California, Berkeley; BA in Economics and History from Washington University in St. Louis

Deepak L. Bhatt profile image

Deepak L. Bhatt

Bristol-Myers Squibb

Chief Medical Officer since 2024

MD from Yale University; MSc in Clinical Epidemiology from the University of Pennsylvania

Published Research Related to This Trial

About 63% of long-term care facilities in the Czech Republic have some form of adverse event reporting process, but many of these systems are underdeveloped and rely mainly on paper records.
Interviews revealed that while staff recognize the importance of reporting adverse events, there is a significant gap in knowledge and skills needed to create effective reporting systems, indicating a need for better training and resources.
Adverse event reporting in Czech long-term care facilities.Hěib, Z., Vychytil, P., Marx, D.[2016]
A symposium with 31 healthcare professionals highlighted that preventing adverse events in community care requires a multi-faceted approach involving policy changes at various levels, including system integration and improved communication among providers.
Key recommendations from the symposium include prioritizing education for clinicians and caregivers, enhancing organizational culture, and leveraging technology to improve patient safety and reduce adverse events.
Adverse events in community care: implications for practice, policy and research.Masotti, P., Green, M., McColl, MA.[2019]
A consensus workshop with 31 healthcare professionals identified and ranked common adverse events in community care, highlighting the need for better understanding of how these events affect care quality.
The workshop emphasized the importance of further research to establish standardized definitions of adverse events and to prioritize research questions that can improve patient safety in community care settings.
Adverse events in community care: developing a research agenda.Masotti, P., Green, M., Shortt, S., et al.[2022]

Citations

Arthritis Extended-Role Practitioners: Impact on Community ...Three trained reviewers used standardized forms to extract data independently. Results: We reviewed 58 charts of adult clients with inflammatory arthritis.
The outcome and cost-effectiveness of nurse-led care in the ...In the community group, 93.5% reported taking no time off work (due to their arthritis) compared with 85.8% of those in the hospital group in ...
Telerheumatology Shared-Care Model: Leveraging the ...Results Data from 124 patients seen between January 2013 and January 2022 were collected; 98% (n = 494/504 visits) were virtual. The average age ...
An evaluation of rheumatology practitioner outreach clinicsTheir clinical and cost effectiveness, compared with Secondary Care (SC) services, has not been assessed. The RECIPROCATE study aims to evaluate ...
Healthcare resource utilization and costs in stable patients ...The nurse-led follow-up for stable patients with RA results in as good or better outcomes and is not associated with increases in healthcare utilization or cost ...
Social Determinants of Health Documentation Among ...Social determinants of health (SDoH), such as poverty, are associated with increased burden and severity of rheumatic and musculoskeletal diseases.
Priorities for High-quality Care in Rheumatoid ArthritisThemes defining high-quality RA care, descriptions of an ideal clinic, areas for improvement, and examples of potential solutions. Theme, Ideal ...
Efficacy of a nurse-led patient education intervention in ...Objective To evaluate the effect of a nurse-led patient education on safety skills of patients with inflammatory arthritis treated with biologic ...
Advancing Patient Safety Innovation in Rheumatology ( ...However, in the results section below we outline the proportions of patients found to have safety errors or adverse events associated with specific ...
Clinical Safety Monitoring in RA Clinical TrialsSome well-recognized RA-specific risks include an increased risk for infection,3 certain malignancies (lymphoma and lung),4,5 and comorbidities ...
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