The Center for BrainHealth is part of an eight- university collaboration that will investigate decision-making in patients with rheumatoid arthritis (RA), an autoimmune disease that affects the whole body. Lead investigator, Susan Blalock, M.P.H., Ph.D., at University of North Carolina at Chapel Hill, approached Center for BrainHealth founder and chief director, Sandra Bond Chapman, Ph.D., about collaborating on the study after reviewing research articles on the cognitive benefits of Strategic Memory Advanced Reasoning Training (SMART), a strategy-based brain training program developed at the Center.

The SMART program strategies target an individual’s ability to “get the essence,” or gist, from densely complex information. Through this collaborative study, researchers hope to improve medication self- management among patients with rheumatoid arthritis.

“RA is a condition that can place patients at increased risk of heart and lung disease,” explained Blalock. “However, many patients are reluctant to use medications that have the potential to cause serious side effects as long as their symptoms like pain, stiffness and fatigue are manageable.”

Researchers aim to determine if providing patients with clearer treatment information and strategies to evaluate that information improve their ability to manage their disease.

“We were very impressed with the increases in reasoning and judgement demonstrated by participants who completed SMART. In the new study, we will see if SMART helps RA patients make more informed decisions concerning the treatment options available to them. It is important that they understand the risks and benefits of all treatment options,” said Blalock.

Researchers will evaluate two different information delivery techniques: A medication guide leaflet that comes with the prescription versus a lay-friendly two-page document that summarizes drug benefits and risks in the DrugFactsBox® format developed by Steven Woloshin, M.D. and Lisa Schwartz, M.D., at Dartmouth University.

“Past studies involving SMART have shown benefits in different populations ranging from traumatic brain injury and financial decision- making to middle school student achievement and older individuals with memory complaints,” said Molly Keebler, M.S., CCC/SLP, head of community programs at the Center for BrainHealth. “We look forward to seeing to what extent SMART can help and empower individuals with RA.”

Other study collaborators include researchers from Carnegie Mellon University, Cornell University, University of Pittsburgh, UT Southwestern Medical Center, and The University of Alabama at Birmingham. The study will include 300 participants and will span three years.

This research is funded by Patient-Centered Outcomes Research Institute (PCORI) through UNC-CH.