title: Role and modalities of information and education in the management of patients with rheumatoid arthritis: development of recommendations for clinical practice based on published evidence and expert opinion.
abstract: OBJECTIVE
  To develop recommendations for the information and education of patients with rheumatoid arthritis (RA) seen in everyday practice, using evidence from the literature, supplemented with expert opinion when needed.
  
  
  METHODS
  A scientific committee developed eight questions using the Delphi consensus procedure. A task force reviewed the literature for answers to these questions, using the PubMed Medline database (1980-2004) and the 2002-2004 databases of the annual meetings held by the French Society for Rheumatology (SFR), the European League Against Rheumatism (EULAR), and the American College of Rheumatology (ACR); the indexing terms for the search were rheumatoid, arthritis, patient, education, information, knowledge, general practitioner, family doctor, and continuing medical education. Only articles in French or English were included. A panel of rheumatologists used the evidence thus compiled to develop recommendations for each question; gaps in evidence were filled by calling on the panelists' expert opinion. For each recommendation, the level of evidence and extent of agreement among panelists were specified.
  
  
  RESULTS
  There were four general questions about the objectives, supports, and mode of delivery (group or one-on-one) of patient information and education, as well as on evaluating knowledge, and four specific questions on program content. The search identified 1235 articles; 144 were selected on the title and 118 of those on the abstract. Three abstracts presented at meetings were also kept. The evidence from the literature was presented to the panelists during interactive workshops. The panelists then developed eight recommendations, all of which were grade D because no published studies specifically addressed everyday clinical practice. Agreement among panelists ranged across recommendations from 85.7% to 100%.
  
  
  CONCLUSIONS
  Recommendations about educating and informing patients with RA in everyday practice were developed. They should increase practice uniformity and ultimately optimize the management of patients with RA.
authors.affiliation: Service de rhumatologie, groupe hospitalier Pitié-Salpêtrière, Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.forename: Thao
authors.initials: T
authors.lastname: Pham
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.forename: Bernard
authors.initials: B
authors.lastname: Combe
authors.forename: René-Marc
authors.initials: RM
authors.lastname: Flipo
authors.forename: Philippe
authors.initials: P
authors.lastname: Goupille
authors.forename: Xavier
authors.initials: X
authors.lastname: Le Loët
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
authors.forename: Xavier
authors.initials: X
authors.lastname: Puéchal
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.forename: Thierry
authors.initials: T
authors.lastname: Schaeverbeke
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.forename: Jacques
authors.initials: J
authors.lastname: Sany
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
mesh_terms: D001172:Arthritis, Rheumatoid / Q000628:therapy*; D003697:Delphi Technique; D006801:Humans; D033181:Information Dissemination; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D011643:Publishing