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THU0560 Efficiency of Patient Education on Early Stage of Rheumatoid Arthritis
  1. E. Orlova1,
  2. D. Karateev2,
  3. L. Denisov1,
  4. A. Kochetkov3,
  5. E. Nasonov4
  1. 1Laboratory of Clinical Trials
  2. 2Early Arthritis department, Nasonova Research Institute of Rheumatology
  3. 3Rehabilitation and Sport Medicine, Central Rehabilitation Hospital, Federal Medical Biological Agency
  4. 4Nasonova Research Institute of Rheumatology, Moscow, Russian Federation

Abstract

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.

References

  1. Riemsma RP, et al. Cochrane Database Sys Rev 2003;2:CD003688.

  2. Ellard DR, et al. Musculoskeletal Care 2009;7(1):17–30.

Disclosure of Interest : None declared

DOI 10.1136/annrheumdis-2014-eular.3737

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