Patient education for adults with rheumatoid arthritis

Riemsma RP, Kirwan JR, Taal E, Rasker HJ

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Summary

Patient education shows short-term benefits for adults with rheumatoid arthritis.

The purpose was to examine the effectiveness of patient education interventions on health status (pain, functional disability, psychological well-being and disease activity) in patients with rheumatoid arthritis (RA). Patient education had a small beneficial effect at first follow-up for disability, joint counts, patient global assessment, psychological status, and depression. At final follow-up (3-14 months) no evidence of significant benefits was found.

This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
This record should be cited as: Riemsma RP, Kirwan JR, Taal E, Rasker HJJ. Patient education for adults with rheumatoid arthritis. Cochrane Database of Systematic Reviews 2003, Issue 2. Art. No.: CD003688. DOI: 10.1002/14651858.CD003688.

This version first published online: April 22. 2002
Last assessed as up-to-date: February 21. 2003

Abstract

Background

Because of the unpredictability people with arthritis face on a daily basis, patient education programmes have become an effective complement to traditional medical treatment giving people with arthritis the strategies and the tools necessary to make daily decisions to cope with the disease.

Objectives

To assess the effectiveness of patient education interventions on health status in patients with rheumatoid arthritis.

Search strategy

We searched MEDLINE, EMBASE and PsycINFO and the Cochrane Controlled Trials Register. A selection of review articles (see references) were examined to identify further relevant publications. There was no language restriction.

Selection criteria

Randomised controlled trials (RCT's) evaluating patient education interventions that included an instructional component and a non-intervention control group; pre- and post-test results available separately for RA, either in the publication or from the studies' authors; and study results presented in full, end-of-study report.

Data collection and analysis

Two reviewers examined and screened search results. Dichotomous items were summarized as relative risk. Standardized mean difference and weighted mean difference were calculated for continuous data. Heterogeneity was assessed using chi square.

Main results

Thirty-one studies with relevant data were included.
We found significant effects of patient education at first follow-up for scores on disability, joint counts, patient global assessment, psychological status, and depression. A trend favouring patient education was found for scores on pain. Physician global assessment was not assessed in any of the included studies. The dimensions of anxiety and disease activity showed no significant effects. At final follow up no significant effects of patient education were found, although there was a trend favouring patient education for scores on disability.

Authors' conclusions

Patient education as provided in the studies reviewed here had small short-term effects on disability, joint counts, patient global assessment, psychological status and depression. There was no evidence of long-term benefits in adults with rheumatoid arthritis.

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