Screening for low literacy in a rheumatology setting: more than 10% of patients cannot read "cartilage," "diagnosis," "rheumatologist," or "symptom".

Objectives: The objectives of the study were to analyze literacy in 194 consecutive patients at an academic rheumatology setting with the Rapid Estimate of Adult Literacy in Medicine (REALM) and an "Arthritis-Adapted" REALM (A-REALM), and to compare responses to one another and to demographic and clinical measures.

Methods: The REALM and A-REALM are two 66-item word recognition tests. Both were administered to 194 consecutive patients in usual rheumatology care.

A controlled trial of a novel primary prevention program for Lyme disease and other tick-borne illnesses.

To evaluate a theory-based educational program to prevent Lyme disease and other tick-borne illnesses (TBI), a randomized controlled trial of an educational program was delivered to ferry passengers traveling to an endemic area in southeastern Massachusetts. Rates of TBI and precautionary and tick check behaviors were measured over three summers in 30,164 passengers. There were lower rates of TBI among participants receiving TBI education compared with control participants receiving bicycle safety education (relative risk [RR] = 0.

Strategies for primary and secondary prevention of Lyme disease.

Lyme disease (borreliosis) incidence continues to increase despite a growing knowledge of primary and secondary prevention strategies. Primary prevention aims to reduce the risk of tick exposure and thereby decrease the incidence of new Lyme disease cases. Secondary prevention targets the development of disease or reduces disease severity among people who have been bitten by infected ticks.

Comprehension of information in three direct-to-consumer television prescription drug advertisements among adults with limited literacy.

Direct-to-consumer (DTC) television advertisements present a number of facts about prescription drug risks and benefits in a brief time. This study assessed comprehension of information in three advertisements among 50 adults with limited literacy. Participants correctly answered an average of 59% of comprehension questions.

A content analysis of direct-to-consumer television prescription drug advertisements.

This article reports the results of a content analysis of 23 direct-to-consumer (DTC) product-specific television prescription drug advertisements broadcast during 2001. A majority of ads used both medical and lay terms to convey medical ideas. Most gave consumers somewhat more time to absorb facts about benefits than those about risks, which could have implications for the "fair balance" requirement.

Literacy demands of product information intended to supplement television direct-to-consumer prescription drug advertisements.

The US Food and Drug Administration (FDA) allows television direct-to-consumer (DTC) prescription drug advertisements that do not fully disclose drug risks if the ads include "adequate provision" for dissemination of the drug's approved labeling. This requirement can be met in part by referring consumers to multiple text sources of product labeling. This study was designed to assess the materials to which consumers were referred in 23 DTC television advertisements.

Predictors of exercise behavior in patients with rheumatoid arthritis 6 months following a visit with their rheumatologist.

Background And Purpose: When factors that influence exercise behavior are known, health care professionals can more likely design and modify patient education materials targeted to promote exercise behavior. This study aimed to identify predictors of exercise behavior in patients with rheumatoid arthritis 6 months after a visit with their rheumatologist.

Subjects And Methods: Twenty-five rheumatologists and 132 patients with rheumatoid arthritis participated.

Asthma: in plain language.

The Community Asthma Program was designed to increase awareness of asthma among urban residents and to bring more people into available care. Educational sessions with patients indicated that many adults struggle with the complicated demands of managing a chronic disease. At the same time, however, a good deal of the written materials meant to provide information and assistance instead make inappropriate demands on the average adult reader.

A randomized clinical trial of a psychoeducational intervention to improve outcomes in systemic lupus erythematosus.

Objective: In a cross-sectional study, we previously identified 2 potentially modifiable risk factors for adverse outcomes in systemic lupus erythematosus (SLE): self-efficacy and social support. The goal of this study was to evaluate in a randomized controlled trial a theory-based intervention to improve patient self-efficacy and partner support to manage SLE.

Methods: Patients with SLE ages 18 years and older who met the American College of Rheumatology criteria and were able to identify a partner (spouse or family member) were recruited from 2 academic medical centers and randomized into an experimental group or a control group.

American Academy of Orthopaedic Surgeons lower limb outcomes assessment instruments. Reliability, validity, and sensitivity to change.

Background: The American Academy of Orthopaedic Surgeons (AAOS) has developed an array of outcomes assessment instruments designed for the efficient collection of outcomes data from patients of all ages with musculoskeletal conditions in all body regions. The Lower Limb Instruments were developed through a process of literature review, consensus-building, and field-testing.

Methods: The instruments were distributed to a total of 290 subjects in twenty orthopaedic practices throughout the United States and Canada.

How rheumatologists and patients with rheumatoid arthritis discuss exercise and the influence of discussions on exercise prescriptions.

Objective: To describe how patients and their rheumatologists discuss exercise, and to identify predictors of exercise prescriptions.

Methods: Twenty-five rheumatologists and 132 patients with rheumatoid arthritis completed questionnaires and were audiotaped during a subsequent clinic visit. Chi-square and t-tests assessed associations between variables.

The importance of patient expectations in predicting functional outcomes after total joint arthroplasty.

Objective: To evaluate the relationship between patient expectations of total joint arthroplasty (TJA) and health related quality of life plus satisfaction 6 months after surgery. Methods. This prospective cohort study included patients undergoing primary total hip (THA) and knee arthroplasty (TKA).

Measuring clinically important changes with patient-oriented questionnaires.

Background: The measurement of the patient's experience with a condition or an illness is an important and quantifiable outcome and an example of action research. By making these concerns paramount, the goals and processes of health care can be redirected from anatomical and physiologic restoration to patient-oriented outcomes. At the same time, research can illuminate the complex mechanisms responsible.

Assessment of pain, depression, and anxiety by visual analogue scale in Japanese women with rheumatoid arthritis.

Assessment of pain, depression, and anxiety by visual analogue scale in Japanese women with rheumatoid arthritis Visual analogue scales (VAS) of depression and anxiety were compared with standard full-length measures of these variables and with VAS of pain (VAS Pain). This was a good way to develop a practical methodology for the routine assessment of pain and affect in rheumatoid arthritis (RA) patients. The reliability of VAS Pain was studied by test-retest.

Comparing patients' and their physicians' assessments of pain.

Patients and their physicians were asked to estimate the pain from needle aspiration and/or injection of joints or soft tissue using the visual analogue scale. On a 10-point scale, the mean score for patients prior to and after the procedure was 4.76 +/- 2.