Evaluation of the patient education program “Live his spondyloarthrtis” from January, 2007 till May, 2014

Abstract

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. One hundred and eighty-six 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, information on the disease and its care, including prevention of complications and management of treatment. One hundred and forty-five 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. Seventy percent 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. Sixty-two percent 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.