Integrating patient education and patient-reported outcome measures improved self-perceived health as well as disease activity and adherence to therapy in patients with rheumatoid arthritis, according to study results.
In a double blind, randomized trial, researchers evaluated 147 patients with rheumatoid arthritis. Patients were treated with disease-modifying antirheumatic drugs and/or biologic therapy, with disease activity and therapy monitored every 3 months for 18 months. Patients completed a patient-reported outcome measures (PROMs) questionnaire before assessment.
At 6 months, 74 patients were allocated to an active group (mean age, 53.2 years; 71.6% women; mean disease duration, 11.4 years) and reviewed their PROMs scores, discussed changes in their disease activity parameters and quality of life with their clinicians and established the best introductory component of a joint fitness program. The other 73 patients served as controls (mean age, 52.8 years; 73.9% women; mean disease duration, 11.1 years) and continued routine standard management based on reviewing their PROMs and clinical assessment. Patients’ medication adherence, Disease Activity Score 28 (DAS28) and PROMs domains were primary outcome measures.
At 18 months, 66 patients (89.1%) in the active group adhered to their drug therapy compared with 47 control patients (64.4%) (P<.01). There was significant difference between groups regarding patient global assessment, pain score, functional disability, quality of life and DAS28.
“At 18-month follow-up, the joint fitness program self-management intervention demonstrated improvement compared to controls for disease activity (effect size, 1.4),” the researchers reported, “while cognitive-behavioral therapy interventions demonstrated similar improvements in active coping skills (effect size 1.2).
“Using patient education was seen to be successful in improving self-perceived health as well as disease activity and had a significant impact on the patient’s function, as well as quality of life. Patient education for patients with inflammatory arthritis is feasible in standard clinical practice.”