Barriers to Implementation of Patient Education in Inflammatory Arthritis

PainRelief.com:  What are the main findings?

Response: Our survey returned a total of 1159 complete responses; most of whom were nurses, rheumatologists, and physiotherapists. 

Using a 0 to 10 rating scale to assess levels of agreement with each recommendation, we found that agreement was very high, all recommendations attaining a median score of 10. However, the degree to which the recommendations were implemented across countries was lower. We found that barriers to implementation included a lack of time, lack of training, lack of staff to provide patient education, and lack of tools to evaluate patient education. 

Things that facilitated following the recommendations included being able to give personalised patient education to individual patients, getting feedback from patients about how education is delivered, and using group education so people can learn from each other.

PainRelief.com: What should readers take away from your report?

Response: Patient education delivered according to the EULAR recommendations can support patients to make informed choices about how to manage their inflammatory arthritis and how best to optimise their health. A high level of agreement with all the recommendations is a very encouraging finding suggesting that the recommendations are acceptable. While there are some barriers to implementing these recommendations, some can be addressed by providing training and developing evaluation tools for patient education.

PainRelief.com: What recommendations do you have for future research as a result of this work?

Response: Barriers to implementation may come from different levels; at the individual, organisation and societal level and all of these will need to be addressed in order to ensure successful implementation of the recommendations into clinical practice.

There is a need for work that looks more at barriers and facilitators in specific countries or areas, especially those that were under-represented in this research.

PainRelief.com: Is there anything else you would like to add?

Response: We have recently explored patients’ agreement with the recommendations [3]. We found that their agreement was very high, suggesting that they reflect patients’ preferences for engaging in collaborative clinical care and using PE to facilitate and supplement their own understanding of IA.

Any disclosures?

This work was funded by the European Alliance of Associations for Rheumatology.

References

  1. Zangi HA, Ndosi M, Adams J, et al. European League Against Rheumatism (EULAR). EULAR recommendations for patient education for people with inflammatory arthritis. Ann Rheum Dis. 2015 Jun;74(6):954-62. https://dx.doi.org/10.1136/annrheumdis-2014-206807 
  2. Sarah E. Bennett, Heidi A. Zangi, et al. Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries.
    Ann Rheum Dis  http://dx.doi.org/10.1136/annrheumdis-2022-222253
  3. Jones B, Bennett S, Larsson I, et al. Disseminating and assessing implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed methods study with patients’ perspectives. RMD Open. 2022;0:e002256. https://dx.doi.org/10.1136/rmdopen-2022-002256 

Citation:

Bennett SE, Zangi HA, Larsson I, et al
Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries
Annals of the Rheumatic Diseases Published Online First: 08 June 2022. 
https://dx.doi.org/10.1136/annrheumdis2022-222253

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