Superio-Cabuslay E, Ward M M, Lorig K R
Patient Education Research Center, Stanford University School of Medicine, Palo Alto, CA 94305, USA.
Arthritis Care Res. 1996 Aug;9(4):292-301. doi: 10.1002/1529-0131(199608)9:4<292::aid-anr1790090414>3.0.co;2-4.
To compare the effects of education interventions and nonsteroidal antiinflammatory drug (NSAID) treatment on pain and functional disability in patients with osteoarthritis (OA), and on pain, functional disability, and tender joint counts in patients with rheumatoid arthritis (RA).
Two meta-analyses were performed: one of controlled trials of patient education interventions and one of placebo-controlled trials of NSAID treatments.
Nineteen patient education trials comprised of 32 treatment arms and 28 NSAID trials comprised of 46 treatment arms were included. The weighted average effect size for pain was 0.17 in the education trials and 0.66 in the NSAID trials. The average effect size for functional disability was 0.03 in the education trials and 0.34 in the NSAID trials; effects of education were much larger in RA studies than in OA studies. In RA studies, the average effect size for the tender joint count was 0.34 in the education trials and 0.43 in the NSAID trials. Because most patients in the education trials were being treated with medications, the effect sizes of these trials represent the additional, or marginal, effects of patient education interventions beyond those achieved by medication.
Based on this meta-analysis, patient education interventions provide additional benefits that are 20-30% as great as the effects of NSAID treatment for pain relief in OA and RA, 40% as great as NSAID treatment for improvement in functional ability in RA, and 60-80% as great as NSAID treatment in reduction in tender joint counts in RA.
比较教育干预和非甾体抗炎药（NSAID）治疗对骨关节炎（OA）患者疼痛和功能障碍的影响，以及对类风湿关节炎（RA）患者疼痛、功能障碍和压痛关节数的影响。
进行了两项荟萃分析：一项是关于患者教育干预的对照试验，另一项是关于NSAID治疗的安慰剂对照试验。
纳入了19项患者教育试验（包括32个治疗组）和28项NSAID试验（包括46个治疗组）。教育试验中疼痛的加权平均效应量为0.17，NSAID试验中为0.66。教育试验中功能障碍的平均效应量为0.03，NSAID试验中为0.34；教育在RA研究中的效果比在OA研究中要大得多。在RA研究中，教育试验中压痛关节数的平均效应量为0.34，NSAID试验中为0.43。由于教育试验中的大多数患者正在接受药物治疗，这些试验的效应量代表了患者教育干预相对于药物治疗所取得效果的额外或边际效应。
基于这项荟萃分析，患者教育干预提供的额外益处相当于NSAID治疗对OA和RA疼痛缓解效果的20%-30%，相当于NSAID治疗对RA功能能力改善效果的40%，相当于NSAID治疗对RA压痛关节数减少效果的60%-80%。
