Effect of communicating personalized rheumatoid arthritis risk on concern for developing RA: A randomized controlled trial

Patient Educ Couns. 2019 May;102(5):976-983. doi: 10.1016/j.pec.2018.12.011. Epub 2018 Dec 10.


Objective: To investigate the effect of providing comprehensive personalized risk information on concern for chronic disease development.

Methods: Unaffected first-degree relatives (FDRs) of rheumatoid arthritis (RA) patients (n = 238) were randomly allocated to: 1) disclosure of RA risk personalized to demographics, genetics, biomarkers, and behaviors using a web-based tool (PRE-RA arm, n = 78); 2) PRE-RA with interpretation by a health educator (PRE-RA Plus arm, n = 80); and 3) standard RA education (Comparison arm, n = 80). Concern for developing RA was assessed at baseline and immediately, 6 weeks, 6 months, and 12 months post-intervention.

Results: FDRs randomized to PRE-RA arms were less concerned about developing RA than the Comparison arm at all post-intervention assessments (p < 0.05). Among those concerned about RA risk at baseline, the PRE-RA (OR = 4.7, 95%CI 1.5-14.4) and PRE-RA Plus (OR = 5.2, 95%CI 1.6-17.3) arms were more likely to have reassurance 6 months post-intervention than the Comparison arm.

Conclusion: A comprehensive tool provided reassurance to those at risk for developing a chronic disease, with or without interpretation from a health educator, compared to standard education.

Practice implications: Individuals may be more likely to be reassured using a personalized chronic disease risk disclosure tool than a standard non-personalized approach.

Keywords: Concern; Genetics; Personalized medicine; Prevention; Rheumatoid arthritis.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / genetics*
  • Biomarkers
  • Communication
  • Female
  • Genetic Predisposition to Disease
  • Health Behavior*
  • Health Education
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Patient Education as Topic / methods*
  • Precision Medicine*
  • Risk Assessment
  • Risk Factors


  • Biomarkers