Background Rheumatoid arthritis (RA) is a chronic, systemic, autoimmune disease which impacting on physical, psychosocial and economic aspects. Poor disease control will cause flare up and remission periodically and increase the risk of deformity. Various studies indicating that patient education on disease knowledge, treatment plan and self-management skill are all contributing factors for disease control and successful coping with long-term condition. However, barriers such as knowledge deficit on disease and related treatments are common in general public, a patient education and empowerment program (PEEP) was then designed and conducted for newly diagnosed RA patients in a regional hospital of Hong Kong.
Objectives To evaluate the effectiveness of PEEP on improving disease control; patient's functional ability and self-management knowledge for newly diagnosed RA patients.
Methods This was a retrospective and observational study, the data retrieved from January 2014 to December 2015. Patients with newly diagnosed RA were recruited into a health education and patient empowerment program (PEEP) conducted by specialist nurse in rheumatology. The program included one-to-one interview in nurse-led clinic and telephone advice line (TAL) support. A health education checklist was designed to standardize the health education content and ensure essential information was delivered to participants. A disease knowledge assessment form to assess disease knowledge, medication management and self-management skill was designed to measure patient's understanding; and health assessment questionnaire (HAQ) was used to assess patient's functional ability and health outcome. Patient's knowledge score accompanied with disease activity score (DAS 28) and HAQ score were collected before and after the PEEP.
Results Until the end of year 2015, totally 73 patients have been recruited into the program. 51 patients attended the program once and 22 patients attended twice. Age of participants between 17 and 79, majority (82.2%) was female. Mean knowledge assessment score was increased from 22.6% to 72% after PEEP, reflecting an average increase of 49.4% in the knowledge of disease, treatment and self-management skill. Mean DAS 28 score before PEEP was 4.44 (2.05 to 7.27) while post PEEP was 3.61 (1.55 to 7.0) which indicated improvement on arthritis control (mean difference -0.83; P<0.0001). Mean HAQ score of pre and post PEEP were 0.84 and 0.59 respectively indicated an improved functional and health outcome. During the study period, TAL support was sought for 41 times, in which 19 episodes were related to drug problems and 10 episodes were related to disease flare up.
Conclusions Health education is an effective way to increase patient's disease knowledge, improve medication management and enhance self-management skill; which also contribute to better disease control and better functional ability. A structured and comprehensive patient education and self-management program should be promoted for all newly diagnosed RA patients.
Disclosure of Interest None declared