Abstract

Objective. Rheumatoid arthritis is a common inflammatory arthritis resulting in joint destruction that leads to physical and functional disability. This condition is characterized by variable disease activity levels, defined as low, moderate, and high. The higher the disease activity the more at risk the patient is for joint joint destruction. The routine use of an approved composite index for disease activity is recommended to assess disease activity level at each office visit. The American College of Rheumatology approved six composite indices; the Patient Activity Scale (PAS), the Patient Activity Scale II (PAS-II), the Routine Assessment of Patient Index Data 3 measures (RAPID 3), the Clinical Disease Activity Index (CDAI), the Disease Activity Score with 28-joint count (ESR or CRP) (DAS28-ESR or DAS28-CRP), and the Simplified Disease Activity Index (SDAI). The RAPID 3 was chosen to implement because it is patient-focused, its ease of use, and it does not require formal joint counts or acute phase reactants values to determine disease activity. Methods. This quality improvement project resulted in the implementation of the RAPID 3 at a rural rheumatology clinic. The RAPID 3 composite index was used to assess disease activity levels in patients with rheumatoid arthritis over a seven-week period. At the end of implementation, the providers were given a questionnaire to evaluate their opinions regarding feasibility, clinical relevance, and satisfaction with using the RAPID 3. The questionnaire was followed by interviews. Results. The results showed that the staff and health care providers found the RAPID 3 to be feasible. It was easily integrated into the clinic workflow, it was easy to score and interpret given the time constraints of office visits. The health care providers found the RAPID 3 clinically relevant, meaning that it interpreted disease activity levels accurately. They also identified the importance of the RAPID 3 and that it should be used on a routine basis. The providers also identified satisfaction with improved communication with their patients, who were focused and ready for the office visit.

Author Details

Christina Mooroian-Pennington, DNP, MSN, NP-C

Sigma Membership

Unknown

Lead Author Affiliation

Northern Arizona University, Flagstaff, Arizona, USA

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

N/A

Keywords:

Rheumatoid arthritis, Assessment instruments, RAPID 3

Advisor

Reynolds, Mary Anne Hales

Second Advisor

Dunn, Dorothy J.

Degree

DNP

Degree Grantor

Northern Arizona University

Degree Year

2016

Rights Holder

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Review Type

Faculty Approved: Degree-based Submission

Acquisition

Self-submission

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