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OP0203-HPR Does Enat-Focused Education Improve Health Outcomes in Ra? A Randomised Controlled Trial
  1. B. Hardware1,
  2. T. Young2,
  3. D.B. Johnson1,
  4. M. Ndosi3,
  5. C. Hale4,
  6. J.R. Maxwell5,
  7. E. Roussou6,
  8. A. Adebajo1
  1. 1Barnsley Hospital NHS Foundation Trust, Barnsley
  2. 2University of Sheffield, Sheffield
  3. 3University of Leeds, Leeds, United Kingdom
  4. 4School of Healthcare, University of Leeds, Leeds
  5. 5Rotherham Hospital NHS Foundation Trust, Rotherham
  6. 6King George Hospital, Ilford, United Kingdom


Objectives The aim of this study was to evaluate the effectiveness of ENAT-focused patient education on self-efficacy, health status and patient knowledge. We hypothesised that, the use of the ENAT to help focus patient education on patients' priority educational needs, would improve their self-efficacy and health status.

Methods This study was a pragmatic 7-centre RCT. The inclusion criteria were: a diagnosis of RA, age 18+ years and ability to complete questionnaires. Patients were randomised to either the ENAT group where patients completed the ENAT which was then used as a template by the Clinical Nurse Specialist (CNS) to meet their educational needs; or usual care by CNS without the ENAT. Patients were seen at baseline then at weeks 16 and 32. The outcomes were self-efficacy (ASES), health status (AIMS2-SF) and patient knowledge (PKQ). We investigated between-group differences (t-test) and trends over time (repeated measures ANOVA). Intention-to-treat results are reported (multiple imputation for missing data) except AIMS2-SF-Work data, where complete case analysis was used for patients who were working.

Results A total of 132 patients were recruited, 70 EG (53%) and 62 UC (47%). Their mean (SD) age was 54 (12.3), 56 (13.3) and disease duration 5.2 (4.9), 6.7 (8.9) for EG and UC respectively. Questionnaire completion rates (EG, UC) were; 97%, 97% (baseline) 90%, 85% (week 16) and 79%, 76% (week 32). Significant between-group differences were found, in favour of the EG at week 32 in ASES-Pain, MD (SE)=-4.36 (1.6), t=-2.72, P=0.008; ASES-Other symptoms, MD (SE)=-5.84 (3.06), t=-3.07, p=0.003; AIMS2-SF Symptoms, MD (SE)=1.04 (0.41), t=5.54, p=0.013 and AIMS2-SF Affect, MD (SE)=0.86 (0.30), t=2.84, p=0.006. Between-group differences were not significant in other time-points or in the total PKQ score.

Table 1 presents within-group changes over time. Scores are mean (SD) after multiple imputations. The ENAT group showed significant improvements in most outcomes while usual care showed significant improvements only on AIMS2-SF work.

Table 1

Conclusions This is the first study to report the effects of ENAT-focused education in people with RA, suggesting improvements in self-efficacy and aspects of health status.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.3541

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