Trial results for a study investigating an implicit bias intervention in rheumatology, including for patients with Osteoarthritis, were posted on ClinicalTrials.gov on 2025-11-12. The intervention led to a statistically significant improvement in the mean percent of quality metrics achieved, with a mean difference of 7.83 (p=0.001).
Background
Addressing implicit bias in healthcare is crucial for ensuring equitable and high-quality care, particularly for patients from historically marginalized groups such as Black/African American and lower socioeconomic status (SES) individuals. In rheumatology, conditions like Osteoarthritis, Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Inflammatory Arthritis require ongoing management and sensitive provider-patient interactions. Implicit biases can affect various aspects of care, including communication, patient adherence to treatment, trust in providers, and overall satisfaction with care. Interventions designed to mitigate these biases aim to improve care delivery and reduce health disparities.
Trial design
This completed study, designated as Phase NA, enrolled 201 participants across conditions including Systemic Lupus Erythematosus, Rheumatoid Arthritis, Inflammatory Arthritis, and Osteoarthritis. The trial investigated the efficacy of a real-time provider-based individuation intervention aimed at improving the receipt of high-quality rheumatic disease care among Black/African American and lower socioeconomic status individuals. The study also sought to determine the effect of the individuation intervention on provider-patient communication, adherence, provider trust, and care satisfaction. Participants were divided into two groups: patients of Arm 1 providers (intervention group) and patients of Arm 2 providers (control group).
Key results
The trial reported several key measurements and analyses:
- Percent of Quality Metrics Achieved:
- Patients of Arm 1 Providers: Mean of 62.14 (Standard Deviation 13.46)
- Patients of Arm 2 Providers: Mean of 54.31 (Standard Deviation 14.46)
Analysis (t-test, 2 sided): A mean difference of 7.83 was observed, with a p-value of 0.001.
- Perception of Patient Centeredness (score on a scale):
- Patients of Arm 1 Providers Enrolled for Audiorecording and Surveys: Mean of 27.5 (Standard Deviation 9)
- Patients of Arm 2 Providers Enrolled for Audiorecording and Surveys: Mean of 23.4 (Standard Deviation 7)
Analysis (t-test, 2 sided): A mean difference of 4.1 was observed, with a p-value of 0.1164.
- Patient Satisfaction (score on a scale):
- Patients of Arm 1 Providers Enrolled for Audiorecording and Surveys: Mean of 50.4 (Standard Deviation 9)
- Patients of Arm 2 Providers Enrolled for Audiorecording and Surveys: Mean of 51.5 (Standard Deviation 8)
Analysis (t-test, 2 sided): A mean difference of -1.1 was observed, with a p-value of 0.6781.
- Everyday Discrimination Scale (score on a scale):
- Patients of Arm 1 Providers Enrolled for Audiorecording and Surveys: Mean of 0.96 (Standard Deviation 0.84)
- Patients of Arm 2 Providers Enrolled for Audiorecording and Surveys: Mean of 1.16 (Standard Deviation 0.93)
Analysis (t-test, 2 sided): A mean difference of -0.2 was observed, with a p-value of 0.4795.
- Adherence (score on a scale):
- Patients of Arm 1 Providers Enrolled for Audiorecording and Surveys: Mean of 54.96 (Standard Deviation 14.15)
- Patients of Arm 2 Providers Enrolled for Audiorecording and Surveys: Mean of 55.99 (Standard Deviation 19.44)
Analysis (Regression, Linear): The p-value for the comparison of 3-month vs. baseline adherence scores in patients of providers in the intervention arm vs. control was 0.056.
- Provider Communication: Positive Emotion Words (Number of words):
- Patients of Arm 1 Providers Enrolled for Audiorecording and Surveys: Mean of 0.99 (Standard Deviation 0.50)
- Patients of Arm 2 Providers Enrolled for Audiorecording and Surveys: Mean of 0.66 (Standard Deviation 0.33)
Analysis (t-test, 2 sided): A mean difference of 0.33 was observed, with a p-value of 0.017.
What this means
The posted results indicate that a real-time provider-based individuation intervention can significantly improve objective measures of care quality and positive emotional communication from rheumatology providers. For patients with conditions like Osteoarthritis, Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Inflammatory Arthritis, particularly those from Black/African American and lower socioeconomic backgrounds, this suggests a potential pathway to more equitable and effective care. While the intervention did not show statistically significant changes in patient satisfaction, perception of patient centeredness, or everyday discrimination in this pilot study, the improvements in quality metrics and provider communication are important steps towards addressing healthcare disparities in rheumatology.
Source
The information regarding these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT05116163, titled "Breaking Implicit Bias Habits: An Individuation Pilot Study In Rheumatology", were posted on 2025-11-12 on clinicaltrials.gov.