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 12 months, 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 12 months, 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.