Background Patient education (PE) is an integral part of the management of inflammatory arthritis (IA). The content of PE and the methods of delivery vary widely across the European countries, preventing comparison and establishment of standards. Currently, there are no formal EULAR recommendations for the content, mode of delivery, timing and evaluation of PE.
Objectives (i) develop evidence-based recommendations/points to consider for people with IA in order to contribute to core standards for PE of people with IA across EULAR countries, (ii) identify the educational needs of rheumatology health professionals in order to effectively implement evidence-based PE and (iii) identify areas in which there is lack of evidence or a need for further research on PE.
Methods The development of the recommendations involved a 15-member task force comprising a multidisciplinary expert panel (nurses, rheumatologists, occupational therapists, a physiotherapist, a psychologist and epidemiologists) and patient representatives, from 10 European countries. They followed the EULAR standardised operating procedures for the elaboration, evaluation, dissemination, and implementation of recommendations . The procedure involves two task force meetings and a systematic literature review. In the first task force meeting, the aims of the project were clarified, a definition of patient education was developed and ten research questions were developed to guide the literature review. A research fellow then conducted the systematic review over a 7-month period, to address the research questions. The task force was then presented with the results of the systematic review before the second meeting in which the recommendations were developed together with the research and education agenda. Following the second meeting, each recommendation was graded according to the level of the supporting evidence and sent to the task force members for final approval and voting.
Results The task force agreed on a common definition of PE and formulated eight recommendations in total. Two recommendations dealt with the need for PE provision as an integral part of standard care in IA, two focused on the content of PE and two on the providers of PE. One recommendation addressed the modes of delivery and one addressed the evaluation of PE (effects). Four of the recommendations were assigned strength of the recommendation “A”, while the rest were assigned strengths ranging from “C” to “D”, according to the level of the supporting evidence. The task force members agreement level was high (mean score for each recommendation was at least 9.4). Finally, the task force agreed on 10 research agenda and three education agenda items.
Conclusion Eight evidence-based and expert opinion-based recommendations have been developed to help establish PE standards across EULAR countries. The implementation of the recommendations can help to bring harmonisation and raise the standard of care for people with IA across Europe. The educational needs of PE providers have been addressed in the recommendations and in the educational agenda. Lastly, areas for further research have been identified.
Dougados, M. et al. EULAR standardised operating procedures for the elaboration, evaluation, dissemination, and implementation of recommendations endorsed by the EULAR standing committees. Ann. Rheum. Dis. 63, 1172-1176, doi:10.1136/ard.2004.023697 (2004).
Disclosure of Interest None declared