Rheumatology and Rehabilitation, Ain Shams University, Cairo, Egypt.
Clin Exp Rheumatol. 2012 Nov-Dec;30(6):899-904. Epub 2012 Dec 17.
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.
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.
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).
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.
评估使用联合健身方案整合患者报告结局（PROMs）和患者教育的效果，以及这种联合方法对疾病活动度和治疗依从性的影响。
这是一项双盲随机对照研究，纳入了 147 名关节炎患者，随访时间为 18 个月。每位患者都完成了一份 PROMs 问卷。在治疗的第 6 个月，患者被随机分配到主动组（74 名患者），他们可以查看之前的自我报告 PROMs 评分，并讨论联合健身计划作为心理教育干预的工具。对照组（73 名患者）继续接受治疗和管理，基于查看他们的记录 PROMs 和临床评估。患者在接下来的 12 个月中每 3 个月评估一次。主要结局是患者对药物治疗的依从性、疾病活动度评分（DAS-28）和 PROMs 各领域的变化。
患者教育和 PROMs 的整合导致疾病活动度参数、DAS-28 评分显著降低，以及患者对治疗的依从性显著提高（p<0.01）。疾病活动度参数的改善与功能障碍和生活质量评分的改善相关。在 18 个月的随访中，自我管理和认知行为疗法干预均显示疾病活动度的改善（效应大小分别为 1.4 和 1.2）。
患者教育和 PROMs 的整合成功改善了自我感知健康和疾病活动度。炎症性关节炎患者的患者教育在标准临床实践中是可行的。
