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Background: Patients' negative expectations about medication can exacerbate side effect burden leading to low adherence and persistence. A novel intervention involves targeting mindsets about non-severe symptoms; reframing them as encouraging signs of medication working., Purpose: This study aimed to assess whether a brief symptom-mindset intervention can improve symptom experience and adherence in patients starting methotrexate to treat an inflammatory rheumatic disease., Methods: A randomized controlled trial was conducted with patients starting methotrexate. Participants were randomly assigned (1:1) to a mindset intervention or standard information control condition. Symptom mindset was assessed after 4 weeks to check intervention efficacy. The primary outcome was symptom experience after 4 weeks. Secondary outcomes were adherence and motivation to take methotrexate (4 weeks), as well as continuation and C-reactive protein (12 weeks)., Results: Forty-seven participants were randomly assigned to the intervention (n = 24) or control group (n = 23). All participants completed the study. After 4 weeks, compared to the control group, intervention participants endorsed more positive symptom mindsets, experienced less symptom burden (mean difference -2.70 [95% CI, -4.50, -0.90] P = .005), fewer general symptoms (3.53 [-6.99, .79] P = .045) and a similar number of methotrexate-specific symptoms (-0.79 [-2.29, 0.71] P = .295). The intervention group had better motivation and adherence to methotrexate at 4 weeks and better continuation, and C-reactive protein at 12 weeks than the control group. There was no difference in side effect attribution., Conclusions: In patients starting methotrexate, a mindset intervention reframing the role of non-severe side effects is a promising approach for improving symptom experience and early stage medication persistence., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Objective: Patients' perceptions about their illness have the power to influence health outcomes. However, existing illness belief measures can be burdensome. Using word clouds to illustrate patients' experiences is potentially a novel solution, but research is lacking in this area. This study aimed to explore whether word clouds illustrate patients' perceptions about their illness and to determine commonalities and differences in experiences of rheumatic diseases., Method: A cross-sectional study was conducted with 323 patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or gout in New Zealand. Participants reported two words describing their inflammatory arthritis experience and completed the Brief Illness Perception Questionnaire. Word clouds were generated from participants' responses, and analysis of variance models were used to explore perceptions between groups., Results: Eleven themes were identified, with each constituting a percentage of total word occurrence and weighting in word clouds. Symptom/sensation was the most prominent theme across all conditions (35%-61%), followed by affect/emotional experience (16%-25%). Theme prevalence varied across word clouds for each condition. Social impact was more prevalent for gout, and burden/intrusion was more prominent for ankylosing spondylitis. Functioning was less prevalent in the gout word cloud than in other conditions. There was moderate overlap between word cloud themes and illness perception domains. Word clouds uniquely identified themes related to burden/intrusion, functioning, opportunity, and social impact of illness., Conclusions: This study supports using word clouds as a low-burden method of examining the experiences of patients with inflammatory arthritis and could be tested with other patient groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Side-effect concerns are a major barrier to vaccination against COVID-19 and other diseases. Identifying cost- and time-efficient interventions to improve vaccine experience and reduce vaccine hesitancy-without withholding information about side effects-is critical., Purpose: Determine whether a brief symptom as positive signals mindset intervention can improve vaccine experience and reduce vaccine hesitancy after the COVID-19 vaccination., Methods: English-speaking adults (18+) were recruited during the 15-min wait period after receiving their second dose of the Pfizer COVID-19 vaccination and were randomly allocated to the symptom as positive signals mindset condition or the treatment as usual control. Participants in the mindset intervention viewed a 3:43-min video explaining how the body responds to vaccinations and how common side effects such as fatigue, sore arm, and fever are signs that the vaccination is helping the body boost immunity. The control group received standard vaccination center information., Results: Mindset participants (N = 260) versus controls (N = 268) reported significantly less worry about symptoms at day 3 [t(506)=2.60, p=.01, d=0.23], fewer symptoms immediately following the vaccine [t(484)=2.75, p=.006, d=0.24], and increased intentions to vaccinate against viruses like COVID-19 in the future [t(514)=-2.57, p=.01, d=0.22]. No significant differences for side-effect frequency at day 3, coping, or impact., Conclusions: This study supports the use of a brief video aimed at reframing symptoms as positive signals to reduce worry and increase future vaccine intentions., Clinical Trial Information: Australian New Zealand Clinical Trials Registry: ACTRN12621000722897p., (© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Behavioral Medicine.)

Objective: To explore whether family-centered communication impacts decisions and optimizes patient-companion-provider consultations., Methods: A parallel, two-arm randomized controlled trial was conducted with 108 participants acting as patients with inflammatory arthritis or companions. Pairs attended a mock consultation where a physician explained the change from a bio-originator to a biosimilar using family-centered or patient-only communication. Participants reported their willingness to transition, risk perceptions, understanding and social support, and completed various scales including the Patient Perception Scale. Interviews helped understand perceptions towards the consultation., Results: Family-centered communication did not impact willingness to change or cognitive risk perceptions compared to patient-only communication. However, it improved emotional risk perceptions (p = 0.047, Cohen's d=.55) and satisfaction with communication (p = 0.015, Cohen's d=.71). Feeling the explanation was reassuring was associated with less worry (p = 0.004). Receiving emotional support (p = 0.014) and companions asking fewer questions (p = 0.046) were associated with higher recall. The intervention improved companion involvement (p < 0.001, Cohen's d= 1.23) and support (p = 0.002, Cohen's d=.86). Interviews showed that encouraging questions, inclusive body language, and acknowledging companions facilitated involvement., Conclusion: Family-centered communication augments patient-companion-provider encounters but does not influence willingness to change treatment., Practice Implications: Practitioners can use family-centered communication when discussing biosimilars but should provide reassurance, encourage emotional support, and summarize key points to improve understanding., (Copyright © 2022 Elsevier B.V. All rights reserved.)