POS1483-HPR A QUANTITATIVE ASSESSMENT OF THE LIKELIHOOD THAT PATIENTS WITH RHEUMATOID ARTHRITIS WILL COMMUNICATE INFORMATION ABOUT RHEUMATOID ARTHRITIS RISK TO RELATIVES
Authors: I. Wells, P. Nightingale, G. Simons, C. Mallen, K. Raza, M. Falahee
Journal: Annals of the Rheumatic Diseases (2021)

Background: First-degree relatives (FDRs) of patients with rheumatoid arthritis (RA) are at increased risk of RA and are being recruited to studies of predictive and preventive approaches. Access to FDRs is usually via the proband with RA. Qualitative investigations have shown that communication of RA risk to FDRs is a complex and selective process. However, quantitative data are needed to develop a robust understanding of this process and its determinants to develop effective communication strategies and support for RA patients and their relatives. Objectives: To identify predictors of the RA patients’ reported likelihood of communicating RA risk information to their FDRs. Methods: Patients with RA were invited to anonymously complete a survey assessing patient characteristics including age, gender, duration of RA, information seeking and decision making preferences (Autonomy Preference Index 1 ), interest in FDRs taking a predictive test for RA, dispositional openness, and the general functioning subscale of the McMaster Family Assessment Device 2 . Reported likelihood of communicating RA risk to each of the patients’ FDRs was assessed using a Likert scale ranging from extremely unlikely (0) to extremely likely (4). The median score across all FDRs was calculated for each patient. The association between patient characteristics and the median score was examined using univariate approaches. Results: Surveys were completed by 482 patients (median age 65 years, 72% female). Most patients reported being likely to communicate RA risk to their FDRs (median score=3). Those who reported their likelihood of communicating RA risk to both children and siblings were more likely to communicate risk to children than siblings ( p&lt; 0.001). No significant difference was found for FDRs’ gender, or patients’ gender, on reported likelihood to communicate about RA risk ( p= 0.32 and p= 0.87, respectively). Patients who were older and who had had RA for longer were less likely to communicate about RA risk with their relatives. Patients who had higher interest in their FDRs taking a predictive test for RA, information seeking preferences, openness to communicate, and family functioning were more likely to communicate about risk (Table 1). Table 1. Descriptive statistics and Spearman’s rank-order correlations for the association between patients’ characteristics and their median reported likelihood of communicating to their FDRs about RA risk Patient characteristics Descriptive statistics Association with median likelihood to communicate risk to relatives Test statistic P value Age; median (IQR ) 65 (55-72) -0.19 &lt;0.001* RA duration ; median (IQR) 10 (4-20) -0.18 0.001* Autonomy preferences Information seeking; median (IQR) 84 (75-97) 0.26 &lt;0.001* Decision making; median (IQR) 54 (42-67) 0.09 0.048 Interest in children taking a test ; median (IQR) 3 (2-3) 0.44 &lt;0.001* Interest in siblings taking a test ; median (IQR) 2 (2-3) 0.44 &lt;0.001* Openness ; median (IQR) 2 (1-3) 0.13 0.004* Family functioning ; median (IQR) 2 (2-3) 0.23 &lt;0.001* * p values significant at the Bonferroni adjusted value of 0.006. Conclusion: Respondents were willing to communicate RA risk to their FDRs, and were more likely to communicate about risk to their children than their siblings. Factors including information seeking preferences, dispositional openness, interest in FDRs taking a predictive test, and family functioning were associated with increased likelihood of communicating RA risk information to FDRs. Patients’ age and RA duration were associated with decreased likelihood. These findings increase understanding of communication about RA risk in families, and will inform the development of informational approaches to support family communication and access to FDRs. References: [1]Ende et al. Journal of General Internal Medicine. 1989; 4(1): 23-30. [2]Epstein et al. Journal of Marital and Family therapy.1983; 9(2): 171-180. Acknowledgements: This work was supported by Versus Arthritis; Grant reference: 21560 and Riksbankens Jubileumsfond (The Swedish Foundation for Humanities and Social Sciences); Grant reference: M13-0260:1 ‘Mind the Risk’. Disclosure of Interests: Imogen Wells: None declared, Peter Nightingale: None declared, Gwenda Simons: None declared, Christian Mallen Grant/research support from: Keele School of Medicine have received funding to support BMS recruit to a non-pharmacological atrial fibrillation trial., Karim Raza Grant/research support from: KR reports grants from Abbvie and Pfizer, and personal fees from Abbvie, Pfizer, Sanofi, Lilly, Bristol Myers Squibb, UCB, Janssen, and Roche Chugai, all outside the submitted work., M. Falahee: None declared