Evaluation of the Patient Education program " Live his spondyloarthrtis " from January, 2007 till May, 2014.
Dr Isabelle TAVARESa, Mr Francesco LOPEZa, Prof Jacques MORELa
a CHU Montpellier
Medical care of ankylosing spondylarthritis combines medications, rehabilitation, and patient’s education.
Prospective evaluation of the impact of a Patient’s Education program dedicated to patients affected by ankylosing spondylarthritis.
Patients and methods
186 patients were involved in this program between 2007 and 2014. They underwent a mean of 25 sessions of multidisciplinary education. A complete team including physiotherapists, occupational therapists, nurses, dietetitians, chiropodists, psychiatrists, Physical Medicine and Rehabilitation doctors, and rheumatologists conducted this program. It included teaching of auto-exercises by physiotherapists and occupational therapists, relaxation, balneotherapy, gymnastics, informations on the disease and its care, including prevention of complications and management of treatment.
145 patients (78 %) completed the follow-up 6 months after the program. The average age of the patients is 42 years [17-78 years], 51 % were men. 70 % carried the gene HLA B27. The disease evolved for 13,6 years with a delay diagnostic of 8 years. 62 % of the patients had a professional activity, 19 % were in incapacity. 62 % were taking non steroidal anti-inflammatory drugs, 45 % were under anti TNF treatment. Among the patients under anti TNF, 84 % made lonely their own injections. 44 % underwent regular physiotherapy, 15 % practised self-rehabilitation.
At the end of the program and at 6 months, 100 % of the patients reported that the program met their needs and expectations. At 6 months, an improvement of the following parameters were observed: BASDAI 0,93 [5,4; 4,1] with p<0.001, BASFI 0,72 [7,41; 4] with p<0.011, EVA disease-1,01 [7; 4] with p=0.011, EVA pain-0,84 [8,4; 4] with p=0.012, stiffness 14,17 [180; 120] with p <0.001, count of pain joints 0,8 [31; 4] with p=0.011. An improvement was also noted concerning cervical mobilities and knowledge of the disease.
Our original program includes a physical and educational care of ankylosing spondylarthritis patients. It reaches initial goals to improve the quality of life of the patients.
Keywords : Patient education- Spondyloarthrtis