Long‐term effects of a nurse‐led group and individual patient education programme for patients with chronic inflammatory polyarthritis – a randomised controlled trial

Abstract

Aims and objectives. To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background. Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period. Design. Randomised controlled trial. Methods. Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n = 71) or a waiting list (n = 70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3). Results. The intervention group had a statistically significant higher global well-being than the controls after 12 months, mean change score 8Á2 (95% CI, 1Á6-14Á8; p-value = 0Á015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2Á6 (95% CI, À1Á8 to 7Á1; p-value = 0Á245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0Á3 (95% CI, À0Á5 to À0Á1; p-value = 0Á001), in the intervention group from baseline to 12 months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis SelfEfficacy Other Symptoms Subscale, mean change À5Á0 (95% CI, À8Á6 to À1Á3; p-value = 0Á008), Arthritis Impact Measurement Scales -2 Social, mean change 0Á3 (95% CI, 0Á1-0Á5; p-value = 0Á008), and Hospital Anxiety and Depression Scale total, mean change 1Á4 (95% CI, 0Á3-2Á5; p-value = 0Á013). Conclusion. A combination of group and individual patient education has a long-term effect on patients' global well-being. Relevance to clinical practice. Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less timeconsuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.

Health status and self‐management in patients with inflammatory arthritis—A five‐year follow‐up study after nurse‐led patient education

“…This is a longitudinal five‐year follow‐up study of a sample of patients that participated in an RCT of hospital‐based nurse‐led patient education (Grønning, Rannestad, Skomsvoll, Rygg, & Steinsbekk, ; Grønning, Skomsvoll, Rannestad, & Steinsbekk, ) from 2008–2010 in mid‐Norway. The RCT was registered in Clinical Trials, NCT00623922.…”

“…al , Grønning et. al ). However, there is a need for longitudinal studies examining whether improvements in psychological status produce carry‐over effects on physical outcomes and which strategies that enhance patients' long‐term adherence to such programmes (Prothero et al, ).…”

Patients’Perceptions of Having a Good Life One Year after Arthritis Patient Education: A Qualitative Study Nested within a Randomized Controlled Trial

“…The informants (n=15) were recruited among the participants included in the RCT (Grønning et al, 2013). The inclusion criteria for the qualitative study were the same as for the RCT.…”

“…The interviews were tape-recorded and took place right after the 12-month follow-up data collection for the RCT (Grønning et al, 2013). Before the interviews were conducted, the research team developed a thematic interview guide (Table 1) based on a literature discussion and previous interviews.…”

Patient education in rheumatoid arthritis: is the needs-based approach the way forward?

“…This validates the underlying latent construct (the educational needs) and enables quantification as well as an accurate estimation of the education needs of people with rheumatic diseases. This has been shown to be useful both in research [13][14][15][16][17][18] and in clinical settings [19]. The ENAT has been shown to help enable patients to effectively identify their educational needs and think of questions which they would not have otherwise considered, before their consultation with the clinician [19].…”