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JANINE-SOPHIE GIRAUDET-LE QUINTREC, ANNE MAYOUX-BENHAMOU, PHILIPPE RAVAUD, KARINE CHAMPION, EMMANUELLE DERNIS, DJAMILA ZERKAK, AMEL OUSLIMANI, JEAN-PIERRE COURPIED, MICHEL REVEL, ANDRÉ KAHAN, and MAXIME DOUGADOS
ABSTRACT. Methods. All consecutive inpatients and outpatients with RA (ACR criteria) were asked to participate in this randomized, prospective, controlled trial. The educational intervention consisted of 8 weekly ambulatory sessions, each lasting 6 hours. Followup was undertaken after 1 year. The primary criterion for judging effectiveness was the Health Assessment Questionnaire (HAQ) score; secondary criteria consisted of coping, medical knowledge, patient global satisfaction, and quality of life scores before the intervention and after 1 year. Results. We asked 1242 inpatients and outpatients to participate in the study: 208 (16.75%) agreed (104 in each group). At baseline, there was no statistically significant difference between the 2 groups. After 1 year, no statistically significant difference was observed between the 2 groups in change in HAQ score: –0.04 ± 0.46 (education group) vs –0.06 ± 0.47 (control group) (p = 0.79). Statistically significant differences were found in 3 domains: patient coping (–1.22 ± 5.55 vs –0.22 ± 3.81; p = 0.03), knowledge (3.42 ± 4.73 vs 0.73 ± 3.78; p < 0.0001), and satisfaction (10.07 ± 11.70 vs 5.72 ± 13.77; p = 0.02), all of which were better for the group attending the education sessions. Conclusion. Despite improvements in patient coping, knowledge, and satisfaction, the education program was not found to be effective at 1 year. There may have been methodological problems relating to the sensitivity of questionnaires and patient selection, and tailored educational interventions should be considered. (First Release June 15 2007; J Rheumatol 2007;34:1684-91) Key Indexing Terms:
PATIENT EDUCATION
From AP-HP, Hôpital Cochin, Université René-Descartes, Faculté de Médecine; and Hôpital Bichat; Départments de Rhumatologie A, Rhumatologie B, Rééducation, Epidémiologie et Biostatistiques, Orthopédie A, Direction de la Recherche Clinique; and Université Paris 7, Paris, France. Supported in part by a grant from the PHRC no. AOM00027. J-S. Giraudet-Le Quintrec, MD; A. Mayoux-Benhamou, MD, AP-HP, Hôpital Cochin, Université René-Descartes, Faculté de Médecine; P. Ravaud, MD, AP-HP, Hôpital Cochin, Université Paris 7, Faculté de Médecine; K. Champion, MD; E. Dernis, MD; D. Zerkak, MD, AP-HP, Hôpital Cochin, Université René-Descartes, Faculté de Médecine; A. Ouslimani, MD, Direction de la Recherche Clinique, Paris; J-P. Courpied, MD; M. Revel, MD; A. Kahan, MD; M. Dougados, MD, AP-HP, Hôpital Cochin, Université René-Descartes, Faculté de Médecine. Address reprint requests to Dr. J-S. Giraudet-Le Quintrec, Rheumatology A, Hôpital Cochin, 27 rue du Faubourg St. Jacques, 75014 Paris, France. E-mail: janine-sophie.lequintrec@cch.ap-hop-paris.fr Accepted for publication March 14, 2007. |
