Arthritis education: the integration of patient-reported outcome measures and patient self-management

Clin Exp Rheumatol. Nov-Dec 2012;30(6):899-904. Epub 2012 Dec 17.

Abstract

Objectives: To assess the integration of PROMs and patient education, using the joint-fitness programme, and the effectiveness of this combined approach on disease activity and adherence to therapy.

Methods: This was a double-blind randomised controlled study which included 147 arthritic patients monitored over 18 months. Every patient completed a PROMs questionnaire. By the 6th month of treatment, the patients were randomly allocated to an active group (74 patients) that was able to view former self-reported PROMs scores and discuss the implementation of the joint fitness programme as a tool for psycho-educational interventions. The control group (73 patients) continued their treatment and management based on viewing their recorded PROMs and clinical assessment. The patients were assessed at 3 monthly intervals for another 12 months. The primary outcome was the change in the patients' adherence to their medications, disease activity score (DAS-28) and PROMs domains.

Results: The integration of patient education and PROMs led to a significant greater reduction of disease activity parameters, DAS-28 score, as well as improvement of the patients' adherence to therapy (p<0.01). The improvement of disease activity parameters was associated with the improvement in functional disability and quality of life scores. At 18-month-follow-up, both the self-management and cognitive behavioural therapy intervention demonstrated improvement for disease activity (effect size 1.4 and 1.2 respectively).

Conclusions: The integration of patient education and PROMs succeeded in improving self-perceived health as well as disease activity. The patient education for patients with inflammatory arthritis is feasible in the standard clinical practice.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Arthritis / diagnosis
  • Arthritis / physiopathology
  • Arthritis / psychology
  • Arthritis / therapy*
  • Cognitive Behavioral Therapy*
  • Combined Modality Therapy
  • Disability Evaluation
  • Double-Blind Method
  • Exercise Therapy
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Joints / pathology
  • Joints / physiopathology*
  • Male
  • Middle Aged
  • Patient Compliance
  • Patient Education as Topic*
  • Perception
  • Quality of Life
  • Recovery of Function
  • Self Care*
  • Self Report*
  • Severity of Illness Index
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Inflammatory Agents