title: Arthritis education: the integration of patient-reported outcome measures and patient self-management.
abstract: OBJECTIVE
  To assess the integration of PROMs and patient education, using the joint-fitness programme, and the effectiveness of this combined approach on disease activity and adherence to therapy.
  
  
  METHODS
  This was a double-blind randomised controlled study which included 147 arthritic patients monitored over 18 months. Every patient completed a PROMs questionnaire. By the 6th month of treatment, the patients were randomly allocated to an active group (74 patients) that was able to view former self-reported PROMs scores and discuss the implementation of the joint fitness programme as a tool for psycho-educational interventions. The control group (73 patients) continued their treatment and management based on viewing their recorded PROMs and clinical assessment. The patients were assessed at 3 monthly intervals for another 12 months. The primary outcome was the change in the patients' adherence to their medications, disease activity score (DAS-28) and PROMs domains.
  
  
  RESULTS
  The integration of patient education and PROMs led to a significant greater reduction of disease activity parameters, DAS-28 score, as well as improvement of the patients' adherence to therapy (p<0.01). The improvement of disease activity parameters was associated with the improvement in functional disability and quality of life scores. At 18-month-follow-up, both the self-management and cognitive behavioural therapy intervention demonstrated improvement for disease activity (effect size 1.4 and 1.2 respectively).
  
  
  CONCLUSIONS
  The integration of patient education and PROMs succeeded in improving self-perceived health as well as disease activity. The patient education for patients with inflammatory arthritis is feasible in the standard clinical practice.
authors.affiliation: Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt. yasser_elmiedany@yahoo.com
authors.forename: Yasser
authors.initials: Y
authors.lastname: El Miedany
authors.forename: Maha
authors.initials: M
authors.lastname: El Gaafary
authors.forename: Nadia
authors.initials: N
authors.lastname: El Arousy
authors.forename: Ihab
authors.initials: I
authors.lastname: Ahmed
authors.forename: Sally
authors.initials: S
authors.lastname: Youssef
authors.forename: Deborah
authors.initials: D
authors.lastname: Palmer
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001168:Arthritis / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D004185:Disability Evaluation; D004311:Double-Blind Method; D005081:Exercise Therapy; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007596:Joints / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D010465:Perception; D011788:Quality of Life; D020127:Recovery of Function; D012648:Self Care; D057566:Self Report; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents