Effects of patient education on compliance with basic treatment regimens and health in recent onset active rheumatoid arthritis

Abstract

Objectives-To determine the eVects of patient education on compliance and on health in patients with active, recent onset rheumatoid arthritis (RA). Methods-A randomised, controlled, assessor blinded, one year trial. The experimental group followed an education programme. All patients started on sulphasalazine therapy. Compliance with sulphasalazine was measured by pill counting. Compliance rates with regimens of physical exercise, endurance activities, and energy conservation were measured by questionnaires. Compliance with prescriptions of joint protection was scored using a test for joint protection performance. Health was measured by a Disease Activity Score (function of erythrocyte sedimentation rate, Ritchie score, and number of swollen joints), C reactive protein, Dutch-AIMS scores, and M-HAQ scores, range of motion of shoulder, elbow, and knee joints. Parameters were scored at baseline and after three, six, and 12 months. Results-Sixty of 65 patients gave informed consent, five of them withdrew from follow up. Compliance with sulphasalazine exceeded 80% with no diVerences between groups. Compliance with physical exercise (at three months), energy conservation (at three and at 12 months), and joint protection (at three months) improved significantly more in the experimental group. The improvements of health were not diVerent in the groups. Conclusion-Compliancewith sulphasalazine among patients with active, recent onset RA is high, whether formal patient education is followed or not. Compliance with physical exercise, energy conservation, and joint protection was increased by patient education. Formal patient education did not improve health status.

Interventions to Enhance Patient Adherence to Medication Prescriptions

“…Brus et al 23 evaluated an intervention involving patient education meetings focusing on compliance both with medication therapy and with a number of physical activities in patients with rheumatoid arthritis. The program was implemented in groups and partners were invited to attend the meetings.…”

A systematic review of the effects of dynamic exercise in rheumatoid arthritis

“…Bearne et al 29 Control group of healthy subjects Bell et al 30 Details of intervention not given Brighton et al 31 Non-dynamic hand exercises only Brus et al 32 …”

Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature

“…Although education about medication and medication use, as well as self-management Review interventions, are often part of the treatment in RA, adherence is seldom reported as an outcome measure in studies into the effect of these interventions [73]. Only three studies assessed the effect of a medication adherence intervention in RA using adherence as an outcome measure [74][75][76]. One study demonstrated an improvement in adherence to d-penicillamine following a patient education program, including seven one-to-one visits of 30 min each [14].…”