Gap between short- and long-term effects of patient education in rheumatoid arthritis patients: a systematic review.
OBJECTIVE
To systematically review educational or psychoeducational interventions for patients with rheumatoid arthritis focusing on long-term effects, especially health status.


METHODS
Two independent reviewers appraised the methodologic quality of the included randomized controlled trials, published between 1980 and July 2002.


RESULTS
Validity scores of studies ranged from 3 to 9 (of 11). The 7 educational programs mainly improved knowledge and compliance in the short and long term, but there was no improvement in health status. All 4 psychoeducational programs improved coping behavior in the short term, 2 of them showing a positive long-term effect on physical or psychological health variables.


CONCLUSIONS
Methodologically better-designed studies had more difficulties demonstrating positive outcome results. Short-term effects in program targets are generally observed, whereas long-term changes in health status are not convincingly demonstrated. There is a need to find better strategies to enhance the transfer of short-term effects into gains in health status.
Niedermann
Karin
K
Department of Rheumatology and Institute for Physical Medicine, University Hospital Zurich, Zurich, Switzerland. karin.niedermann@usz.ch
Fransen
Jaap
J
Knols
Ruud
R
Uebelhart
Daniel
D
D000223:Adaptation, Psychological; D001172:Arthritis, Rheumatoid / Q000503:physiopathology* / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D019359:Knowledge; D010349:Patient Compliance; D010353:Patient Education as Topic / Q000379:methods / Q000592:standards*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D013997:Time Factors