To evaluate the effectiveness of the DrugFactsBox® format for presenting written medication information and the SMART (Strategic Memory Advanced Reasoning Training) Program designed to enhance gist reasoning ability. We used a 2 x 2 factorial research design. Two hundred eighty-six patients with rheumatoid arthritis were randomly assigned to one of four groups: DrugFactsBox® Only, DrugFactsBox® Plus SMART, Other Consumer Medication Information (CMI) Only, and Other CMI Plus SMART. Data were collected via telephone interviews and online questionnaires at four-time points: Baseline and 6‐weeks, 3‐months, and 6‐months following baseline. The primary outcome variable was Informed Decision‐Making, defined as making a value‐consistent decision concerning the use of disease-modifying antirheumatic drugs based on adequate knowledge.

We found no main effects for the two interventions, either alone or in combination. However, there was a significant interaction between the SMART/No SMART Program and Informed Decision‐Making at baseline. Among participants in the SMART groups who did not meet the criteria for Informed Decision‐Making at baseline, 42.5% met the criteria at the 6‐month follow‐up, compared to 23.6% of the No SMART groups (Mean Difference=18.9, 95% CI=5.6, 32.2, p=0.007). This difference was driven by increased knowledge in the SMART groups. Among participants who met the criteria for Informed Decision‐Making at baseline, the difference between the SMART and No SMART groups was not statistically significant.

Participation in a theory‐driven program to enhance gist reasoning may positively affect Informed Decision‐Making among patients with inadequate knowledge concerning therapeutic options.