Long-term effects of a nurse-led group and individual patient education programme for patients with chronic inflammatory polyarthritis - a randomised controlled trial

Aims and objectives. To investigate the long-term effect of a nurse-led hospital-based patient education programme combining group and individual education for patients with chronic inflammatory polyarthritis. Background. Patient education interventions have shown short-term effects, but few studies have investigated whether the effects are sustained for a longer period. Design Randomised controlled trial. Methods. Patients with rheumatoid arthritis, psoriatic arthritis and unspecified polyarthritis were randomised to the intervention group (n=71) or a waiting list (n=70). Primary outcomes were as follows: Global Well-Being and the Arthritis Self-Efficacy Other Symptoms Subscale. Secondary outcomes were as follows: patient activation, physical and psychological health status, patients' educational needs and a Disease Activity Score (DAS28-3). Results. The intervention group had a statistically significant higher global well-being than the controls after 12months, mean change score 8.2 (95% CI, 1.6-14.8; p-value=0.015), but not in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change score 2.6 (95% CI, -1.8 to 7.1; p-value=0.245). Within each group, analyses showed a statistically significant improvement in DAS28-3, mean change -0.3 (95% CI, -0.5 to -0.1; p-value=0.001), in the intervention group from baseline to 12months, but not in the controls. The controls had a statistically significant deterioration in the Arthritis Self-Efficacy Other Symptoms Subscale, mean change -5.0 (95% CI, -8.6 to -1.3; p-value=0.008), Arthritis Impact Measurement Scales - 2 Social, mean change 0.3 (95% CI, 0.1-0.5; p-value=0.008), and Hospital Anxiety and Depression Scale total, mean change 1.4 (95% CI, 0.3-2.5; p-value=0.013). Conclusion. A combination of group and individual patient education has a long-term effect on patients' global well-being. Relevance to clinical practice. Nurses should consider whether a combination of group and individual patient education for patients with chronic inflammatory polyarthritis is an alternative in their clinical practice. This combination is less time-consuming for the patients, and it includes the benefit of group learning in addition to focusing on patient's individual educational needs.