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AB0670 Ankylosing Spondylitis (AS-P) Patient Centred Education Program Improves Disease Activity and Quality of Life up To 12 Months
  1. C.A. Inderjeeth1,2,
  2. W. Raymond3,
  3. C. Connor4,
  4. J. Edelman5,
  5. N. Cook4,
  6. K. Briffa6,
  7. J. McQuade4
  1. 1Rehabilitation & Aged Care, Sir Charles Gairdner Hospital
  2. 2School of Medicine & Pharmacology, The University of Western Australia
  3. 3Sir Charles Gairdner Hospital
  4. 4Arthritis & Osteoporosis Foundation of WA
  5. 5Rheumatology, Sir Charles Gairdner Hospital
  6. 6Physiotherapy & Exercise Science, Curtin University of Technology, Perth, Australia

Abstract

Background Patient centered education interventions are rare. After a needs assessment, focus group consultation, and execution of a Plan, Do, Study, Act (PDSA) model, we developed and delivered a multidimensional Ankylosing Spondylitis Education Program (AS-P) to patients referred via a rheumatologist (meeting the New York criteria for AS).

Objectives To examine the benefits of AS-P for people with Ankylosing Spondylitis (AS) in regards to health status, quality of life and disease activity.

Methods 79 people were recruited in the intervention. Exclusion criteria: <18yo; non-English speaking; comorbid inflammatory musculoskeletal disease; and/or visual, auditory, or cognitive impairment. Participants attended a weekly 2.5 hour patient centered education session facilitated by same two health professionals over 6 weeks. The scripted content included multidimensional strategies including stretches; self-efficacy and self-management constructs and optional 7th week supervised exercise class.

Data collection included demographic, AS disease management characteristics, medication patterns, and outcomes, measured at baseline, 6 weeks, 3 months, 6 months and 12 months using GLM repeated measures ANOVA. Additional outcomes included the: BAS-G, BASDAI, AS-Qol, BASFI, back pain (VAS), PDGA, anxiety (HADs), health distress (HDQ), quality of life (EASIQol), perceived health (GPH), pain (PSEQ), MAFs and SF-36.

Results At baseline, 43.3% were male and the mean age was 43.5 ±14.5 years. The median time to AS diagnosis from the index symptom experience was 4 years IQR (1–11). The only significant change in medication usage occurred between Month 3 to Month 6 (p=0.018).

The BAS-G, BASDAI and the AS-QoL had improved between baseline to 3, 6 and 12 months (all p<0.05). Nocturnal and total back pain had improved between baseline and 12 months (all p<0.05). The PDGA and HDQ had improved between baseline and 12 months (all p<0.05). The EASI-QOL (physical health composite) had improved at 3 and 12 months (p<0.05). There was also a positive trend in the EASIQOL disease activity, emotional state and social composite scores (p>0.05). MAFs demonstrated a sustained improvement over 12 months (p=0.011). Similarly, the SF-36 physical (p=0.001) and mental (p=0.002) composite scores had improved 12 months post-intervention.

BASFI (p=0.271) and HADs (p=0.086) demonstrated no improvement 12 months post-intervention.

Conclusions AS-P for AS is effective in improving AS specific disease activity, pain and QOL scores for up to 12 months.

  1. Von Korff, M et al (2002) Organising care for chronic illness. BMJ 325: 92–94.

  2. Zochling, J (2011) Measures of symptoms and disease status in ankylosing spondylitis. Arthritis Care & Research 63: S47-S58.

Disclosure of Interest None declared

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