Background Patient education is part of disease management of inflammatory rheumatic diseases. According to the guidelines (1), the rheumatologist has a role in proposing education, follow up, and may possibly participate in programs. The detection of unmet educational needs by the rheumatologist may increase the patients motivation to entering a program.
Objectives The objectives were (1) to assess the feasibility of a systematic procedure to detect patients educational needs in current practice (2) to determine the type of patients needs and their willingness to be involved in an education program.
Methods In a monocentric pragmatic prospective pilot study, the rheumatologist invited patients suffering from rheumatoid arthritis and spondylarthritis to complete an auto questionnaire of educational diagnosis. All patients were out patients. The questionnaire was elaborated according to the guidelines (1) and included 6 domains: knowledge and beliefs about disease and treatments,impact on family and social life, impact on professional life, emotional well being, management by the health care system. For each domain, patients were asked whether they encountered difficulties or needed more information or help. The reasons why the questionnaire could not be proposed were collected. The acceptability of the questionnaire was assessed.
Results The questionnaire could be proposed by the rheumatologist to 68 patients of the 120 out patients during a 4 month period in hospital or private practice. 53/68 (78%) questionnaires were completed. The reasons of non distribution were: lack of time (27), outstanding or severe medical problems (20), omission (11), language or cognitive barriers (6), recent contact with an education program (6), other (10). Some patients experiencing language or cultural barriers were helped by a hospital pharmacist to fulfil the questionnaire. 74 questionnaires were finally analysed. Patients had RA (55) or spondylarthritis (19), mean age was 57 ans (24-87).
64% patients expressed at least one educational need. Patients uncountered difficulties or needed information and help relating respectively to the disease (14%/55%), treatment (10%/39%), social and family life (33%/35%), professional life (53%/44%), health care system (11%/35%), emotional status (38%/49%).There was no significant difference between the expression of at leat one educational need and age, type of arthritis, duration of disease, hospital or private care, biologic treatment.
61% patients wished to meet another health professional or other patients. The questionnaire was considered helpful by 77% patients. Only 8% patients found the questionnaire too long and none thought it was intrusive.
Conclusions Detection of patients educational needs in current practice is feasible using an auto questionnaire with good acceptability. This procedure, proposed by the rheumatologist in charge of the patient, may enhance the patient’s motivation and initiate an educational approach focusing on the patients who need most attention. For some patients having language or cultural barriers, the help of another professional is essential.
2007 Therapeutic patient educaton. Guidelines. French National Health Authority
Disclosure of Interest None Declared