BrainHealth's SMART methodology helps patients make more informed treatment decisions

Researchers at Center for BrainHealth, part of The University of Texas at Dallas, collaborated with scientists at the University of North Carolina at Chapel Hill to examine whether the Strategic Memory Advanced Reasoning Training (SMART) program affects people's abilities to make informed decisions about their medical treatment options. Patients with rheumatoid arthritis, in particular, are often reluctant to take antirheumatic drugs because of perceptions about the drugs' risks and benefits. The findings from this study point to an approach that helps these patients, and other people, make more informed decisions about their health.

The study, accepted for publication in Arthritis Care & Research (August 2020), was authored by lead researcher Susan J. Blalock, Ph.D., a now-retired professor from the University of North Carolina at Chapel Hill, and a research team that featured Sandra Bond Chapman, Ph.D., founder and chief director of the Center for BrainHealth, and Molly Keebler, former head of community programs at the Center for BrainHealth.

SMART teaches evidence-based strategies and techniques that improve strategic thinking, increase productivity and foster innovation. It was developed and tested by BrainHealth researchers over the past three decades.

The findings build on previous work that suggests the SMART program helps people understand the gist, or bottom-line meaning, of complex information. As part of the study, patients with rheumatoid arthritis were asked questions about how they value the risks and rewards of certain antirheumatic drugs. Six months after they participated in the SMART program, participants that initially had inadequate knowledge of the risks and rewards of treatment options made more informed decisions because they became more knowledgeable about the drugs.

The SMART protocol helps improve gist reasoning abilities—how well people can understand the overall gist or essence of complex information such as medication pamphlets and doctor's recommendations. "Rather than getting overwhelmed by the immense number of warnings, possible risks and outcomes, participants learn to focus on the major facts rather than all the less relevant details, to reach an informed decision aligned with their personal values," said Chapman.

This research has broader implications, such that the SMART methodology could help others with a variety of chronic conditions strategically focus on key inputs to make more informed decisions consistent with their belief systems about their health.

"We helped empower people to ask questions and focus more effectively on the most important facts within complex information by following a SMART protocol. We got them thinking about the big picture and gave them the confidence to be informed users of medical advice—actively engaged in making decisions about their healthcare," said Chapman.