No abstract

Background:Chronic inflammatory rheumatisms (RIC) may negatively impact patients’ sexual health and quality of life.Overall, 31 to 76% patients suffering from rheumatoid arthritis (RA) report to suffer from sexual difficulties. Patients affected by spondyloarthritis (SA) report a negative disease impact on sexual activity in 38 to 50% of cases. On the other hand, while healthcare professionals (HP) are well aware of the utility to approach this issue, most do not carry on with it for they feel insufficiently trained in this domain.According to the 2015 EULAR recommendations, therapeutic patient education (TPE) is an essential part of patient management in the RIC domain. TPE actually does take into account the overall patient experience including sexuality.A survey primarily focused on needs and conducted among patients and healthcare experts involved in TPE was thus deemed necessary to better define both the content and format of TPE to be delivered to HP in order to help them dialogue with their patients, while overcoming certain obstacles on this path.Objectives:To define the educational needs of HP involved in TPE of patients suffering from CIR concerning sexual health issues.Methods:Using an interdisciplinary team approach, we have elaborated two different questionnaires focused on assessing specific needs and designed for patients and healthcare professionals. These questionnaires were filled in online from May 2017 to November 2017 via a secured server implemented in each of the 14 French rheumatology centers by CIR patients, TPE-involved HP, and members of three patient associations.Results:239 patients answered the questionnaire (60.7% suffering from SA, 6.7% from psoriasis rheumatism, and 32.6% from RA), as did 57 HP. Overall, 72% patients reported having suffered or being still suffering from sexual difficulties, whereas 80% of them had never approached the topic with their respective HP.In 82% of cases, the patient claimed having addressed the issue, whereas 30% HPs reported having taken the initiative. Half of both the patients and HP reported they had not dared to approach the topic. To ease communication, HP would appreciate to “have a team specifically dedicated to particular sexual healthcare issues”, “have specific tools available” and “undergo specific training sessions”.In line with HP answers, patients’ primary expectations were to be heard and become well-informed. The people who were judged the most competent (63%) and with whom patients would feel the most secure (58%) were the psychologists. The topics thought to be the most useful by the patients were similar to those considered most useful for HP training, namely undesirable treatment effects on sexuality (95%), impact of rheumatism on sexual activity (92%), body image and chronic illness (81%), partner communication (77%), sexual dysfunctions (77%), as well as physiology of aging and sexual function (75%). About 70% HP expressed the need for complementary education, with 95% of them stressing the necessity to acquire further communicati...