Background Patient education is an important component of the care for patients with rheumatoid arthritis (RA), giving the possibilities for self-management of the disease [1, 2].
Objectives To develop the education program for patients with RA and to evaluate its efficiency on early stage of the disease.
Methods The group-education program was developed with the support of the Russian National Public Organization of Disabled People NADEZHDA (Hope) and consisted of 4 daily 90-min education lessons. All information was presented by a multidisciplinary team (rheumatologist, cardiologist, psychologist, physiotherapist and occupational therapist). 55 patients with early RA (83,6% females, age of 18 to 62 years, disease duration of 2 to 22 months) were included. 25 study group patients were trained according to the education program, 30 received only drug therapy (control). Tender and swollen joint count, ESR, joint pain on 100-mm VAS, DAS28, HAQ, RAPID3, hand grip strength, the average powers of knee extension and ankle flexion by the EN-TreeM movement analysis were evaluated at baseline and following 3 and 6 months. Adherence to non-drug treatments was assessed by the special patient questionnaire.
Results After 3 and 6 months in the study group the adherence to joint protection strategies increased by 13,0 and 10,0 times (p<0,01), to regular physical activity – by 4,0 and 3,25 times (p<0,01), the compliance to use functional wrist orthoses – by 2,0 times and 75,0% (p<0,01), knee orthoses – by 33,3% and 50,0% (p<0,05), orthopedic insoles – by 71,4% and 57,1% (p<0,01), respectively. After 6 months, there were statistically significant differences between the 2 groups in changes of most parameters (p<0,05), excluding ESR, DAS28, the grip strength of a more affected hand and the extension power of a weaker knee (p>0,05). 6 months following education program participation, there was significantly more frequently a good response to treatment according to the EULAR criteria (DAS28) (56,3% vs 40,0% in the control group, p<0,05).
Conclusions The education program improves functional status and quality of life, helps to control diseases activity in patients with early RA within 6 months. Patient education enhances adherence to non-drug therapies. The maximum positive result was achieved after 3 months; this effect slightly diminished at 6 months. This necessitates retraining in the following 3–6 months.
Riemsma RP, et al. Cochrane Database Sys Rev 2003;2:CD003688.
Ellard DR, et al. Musculoskeletal Care 2009;7(1):17–30.
Disclosure of Interest : None declared