Effect of a collective educational program for patients with rheumatoid arthritis: a prospective 12-month randomized controlled trial.
OBJECTIVE
To evaluate the effect on health and functional status of an 8-week group-education program for rheumatoid arthritis (RA) in addition to usual medical care.


METHODS
All consecutive inpatients and outpatients with RA (ACR criteria) were asked to participate in this randomized, prospective, controlled trial. The educational intervention consisted of 8 weekly ambulatory sessions, each lasting 6 hours. Followup was undertaken after 1 year. The primary criterion for judging effectiveness was the Health Assessment Questionnaire (HAQ) score; secondary criteria consisted of coping, medical knowledge, patient global satisfaction, and quality of life scores before the intervention and after 1 year.


RESULTS
We asked 1242 inpatients and outpatients to participate in the study: 208 (16.75%) agreed (104 in each group). At baseline, there was no statistically significant difference between the 2 groups. After 1 year, no statistically significant difference was observed between the 2 groups in change in HAQ score: -0.04 +/- 0.46 (education group) vs -0.06 +/- 0.47 (control group) (p = 0.79). Statistically significant differences were found in 3 domains: patient coping (-1.22 +/- 5.55 vs -0.22 +/- 3.81; p = 0.03), knowledge (3.42 +/- 4.73 vs 0.73 +/- 3.78; p < 0.0001), and satisfaction (10.07 +/- 11.70 vs 5.72 +/- 13.77; p = 0.02), all of which were better for the group attending the education sessions.


CONCLUSIONS
Despite improvements in patient coping, knowledge, and satisfaction, the education program was not found to be effective at 1 year. There may have been methodological problems relating to the sensitivity of questionnaires and patient selection, and tailored educational interventions should be considered.
Giraudet-Le Quintrec
Janine-Sophie
JS
AP-HP, Hôpital Cochin, Université René-Descartes, Faculté de Médecine, Paris, France. janine-sophie.lequintrec@cch.ap-hop-paris.fr
Mayoux-Benhamou
Anne
A
Ravaud
Philippe
P
Champion
Karine
K
Dernis
Emmanuelle
E
Zerkak
Djamila
D
Ouslimani
Amel
A
Courpied
Jean-Pierre
JP
Revel
Michel
M
Kahan
André
A
Dougados
Maxime
M
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000534:rehabilitation*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000379:methods*; D017060:Patient Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D012648:Self Care / Q000379:methods*; D012680:Sensitivity and Specificity