By Janet Howard

Arthritis educators can provide a meaningful boost to traditional care for patients with rheumatic diseases, according to a new study reported in Arthritis Care and Research. Teaching and support by trained educators has been proven to have a positive impact on the knowledge and satisfaction with services for patients with arthritis visiting rheumatology clinics.

"People with arthritis are often dissatisfied with their care. We have shown that arthritis patient educators can be a useful addition to traditional rheumatology care," remarks coauthor Peter Lipsky, M.D., NIAMS scientific director. "We now know for certain that patient education positively affects patient knowledge, disease management, and satisfaction with clinic services."

In the study carried out at the University of Texas Southwestern Medical Center in Dallas, one group of patients with arthritis was randomly assigned to an arthritis patient educator as well as standard rheumatologic care. A control group was assigned to receive only standard rheumatologic care. Both groups completed standard assessment tests: the Arthritis Impact Measurement Scales 2 and the Arthritis Self-Efficacy Scale. After meeting with the rheumatologist, each patient in the test group met with an arthritis patient educator for educational and social support. One week later, members of this group received a followup phone call from the educator to determine whether the patient had unanswered questions or needed additional support. Eight weeks later, both groups completed the baseline questionnaire again, as well as a basic knowledge test and a satisfaction survey.

The results showed that the patients who received the intervention showed a more overall knowledge about their disease than patients who did not. Of this group, 88.5 percent rated the arthritis patient educators "good" or "excellent"; 69 percent found the educators helpful; and 58 percent requested further interactions with the educators. Test group patients were able to name more sources of arthritis information and self-help aids.

Arthritis patient educators are people with arthritis who have received training from a panel of rheumatologists, social workers, occupational therapists, dietitians, and an arthritis patient educator. Training also includes discussions of cultural diversity, interviewing and listening skills, and role-playing.

Because arthritis is the most costly, chronic, and common disease known, the goal of arthritis management has been to minimize pain, inflammation, disability, and the psychosocial changes associated with the disease. Currently, arthritis affects over 40 million (15 percent) of the American population, and the number is expected to increase to nearly 20 percent (60 million) by 2020. It is the leading cause of disability in Americans over 65.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases is to support research into the causes, treatment, and prevention of arthritis and musculoskeletal and skin diseases, the training of basic and clinical scientists to carry out this research, and the dissemination of information on research progress in these diseases.

Branch V, Lipsky K, Nieman T, Lipsky P. Positive impact of an intervention by arthritis patient educators on knowledge and satisfaction of patients in a rheumatology practice. Arthritis Care and Research 1999;12(6):370-375.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the National Institutes of Health (NIH), leads the Federal medical research effort in arthritis and musculoskeletal and skin diseases. The NIAMS supports research and research training throughout the United States, as well as on the NIH campus in Bethesda, MD, and disseminates health and research information. The National Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse (NAMSIC) is a public service sponsored by the NIAMS that provides health information and information sources. Additional information can be found on the NIAMS Web site at http://www.niams.nih.gov/.

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