The Health Log: A Randomized Clinical Trial

The Patient-Centered Outcomes Initiative (PACO) was developed at Brigham and Women's
Hospital (BWH) to create a replicable model of patient-centered care that will improve
treatment for patients with rheumatoid arthritis (RA) and lead to improved outcomes. This
work began with focus groups of RA patients to determine which changes or programs they felt
were needed. Among the suggestions was a health management tool to improve doctor-patient
communication. The Patient Advisory Committee (PAC), a part of PACO which grew out of the
focus groups, worked to develop the current Health Log. It consists of a permanent booklet
and a refillable health log version that is filled out before each doctor's appointment.

Health management tools have also been developed for patients with other chronic conditions.
Dr. Paul Fortin of the University Health Network developed the Lupus Health Passport, which
helps patients keep track of their health and also has information about lupus as well as
prevention of coronary artery disease (CAD) and osteoporosis.

However, although these health management tools have been well received, they have not been
studied to see if they improve self-efficacy. We would like to determine if the use of the
Health Log improves self-efficacy in RA patients over time.

Specifically we will be looking to:

1. Determine if this health management tool improves self-efficacy over time with use, as
measured by the Self-Efficacy Other Symptoms Scale of the Arthritis Self-Efficacy
Questionnaire.

2. Determine if this health management tool improves satisfaction with the doctor's visit
as measured by a VAS scale 10-100.

3. Determine if this health management tool improves agreement with the statement "How
satisfied are you that your concerns were addressed during your clinic visit today", as
measured by a VAS scale 10-100.

Inclusion Criteria:

- billing diagnosis of rheumatoid arthritis (714.0) or seronegative inflammatory
arthritis and a member of the BRASS study at Brigham and Women's Hospital

Exclusion Criteria:

- less than 18 years of age