Facilitating the use of COBRA combination therapy in early rheumatoid arthritis: A pilot implementation study
van Tuyl LHD et al. – Study reports that rheumatologists, patients, and arthritis nurses all highly appreciated the implementation package of COBRA in Dutch clinical practice and also indicated that its availability would increase uptake of COBRA therapy. Methods- Combinatietherapie Bij Reumatoide Artritis (COBRA) therapy is a step-down combination therapy with prednisolone, methotrexate (MTX), and sulfasalazine (SSZ)
- A pilot testing of an implementation package to facilitate prescription and use of COBRA therapy in Dutch population with early RA is described
- This was developed to address specific barriers towards prescription of COBRA therapy and comprised of:
- Informational handouts (an information booklet and leaflet for pts)
- Preprinted prescription orders, and
- Background information on COBRA therapy for rheumatologists
- 22 rheumatologists participated, including the arthritis nurse where available
- They were asked to record their experience
Results- 16 rheumatologists and 10 arthritis nurses prescribed COBRA therapy to 27 pts
- 88% of rheumatologists reported that the material sped up the prescription process
- 65% indicated they would prescribe COBRA therapy more frequently if these materials were available routinely
- Pts expressed great satisfaction with the information handouts
- 89% pts planned to keep the information booklet as a reference; 70% used it as a tool to remember the correct intake of medication
- Attitude and perceived capability of nurses towards the guidance of pts receiving COBRA therapy was improved through a brief educational intervention
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