Background There is a growing body of evidence to support the effectiveness of education programs for patients with arthritis. However, there has been little investigation into education strategies for patients with axial spondyloarthritis (axSpA). A number of studies examining education strategies for patients with arthritis have involved an interdisciplinary approach and found positive impact on disease activity, function and overall health (1). Furthermore, the use of electronic formats for education are preferred over other formats for patients with axSpA (2). As such, the Toronto Western Hospital Spondylitis Program developed a novel e-Learning education module for patients with axSpA with input from patients and an interdisciplinary team of health care professionals. The module consists of an interactive web-based platform covering evidence-based topics including diagnosis, treatment and self-management for axSpA.
Objectives To measure the effect of the axSpA e-Learning patient education module with respect to: 1) chronic disease self-efficacy; 2) knowledge of axSpA, and 3) exercise behaviour.
Methods Fifty-four adult patients with axSpA attending a tertiary academic spondylitis clinic were randomly assigned to one of two groups: 1) e-Learning intervention, where patients were emailed a link to the web-based patient education module and were asked to complete the module at their leisure; or, 2) usual care. All patients completed baseline and follow-up questionnaires that included: the Ankylosing Spondylitis (AS): “what do you know” knowledge questionnaire; Stanford Chronic Disease Self-Efficacy Scale (CDSE), and, the Stanford questionnaire for Exercise Behaviours.
Results Twenty-one patients with axSpA completed the e-Learning module and 33 patients continued with usual care. Overall, mean (SD) age was 42.6 (13.2) years, 70% were male, mean (SD) disease duration was 19.3 (10.1) years and 85% had a post-secondary education. There were no statistically significant differences in the above outcome measures between the two groups at baseline or follow-up. However there was significant improvement from baseline to follow-up in patients that completed the e-Learning module with respect to their AS knowledge mean score (SD) 19.0 (4.1) vs 19.9 (5.0) (p=0.0002) and CDSE sub-scale “manage disease in general” mean score (SD) regarding when to visit a doctor and ability to manage health condition 7.5 (1.8) vs. 7.9 (1.9) (p=0.02) and 7.3 (1.8) vs. 7.9 (2.1) (p=0.02) respectively.
Conclusions The above demonstrates an increase in overall disease knowledge and improved self-efficacy through the implementation of a novel e-Learning patient education module. This e-Learning module has the potential to provide benefit to patients with axSpA who have limited access to specialized care, ultimately optimizing outcomes in this patient population.
Vliet Vlieland TP. Multidisciplinary team care and outcomes in rheumatoid arthritis. Curr Opin Rheumatol 2004;16(2):153–6
Utilization of an informational needs assessment to develop an education program for patients with ankylosing spondylitis and related axial spondyloarthritis R. Kang1, L. Passalent, R. Morton, C. Hawke, J. Blair4, A. Lake2, M. Doucet5, D. MacGarvie2, K. Wong6, R. Inman Annals of the Rheumatic Diseases 2014; 72(Suppl 3):A1037-A1038.
Disclosure of Interest None declared