Patient Education Sessions Research Articles

Comparison of group versus individual patient education for promoting safety skills of patients with autoimmune rheumatic diseases treated with biologics: a multicentre randomised controlled trial.

To evaluate the effectiveness of a nurse-led intervention combining face-to-face and group education sessions for the acquisition of safety skills by patients with autoimmune rheumatic diseases treated with biologics. This multicentre randomised controlled trial compared two individual patient education sessions against a combination of an individual session at baseline and a group session 3months later. The primary outcome was a validated questionnaire (BioSecure) scored at 6 and 12 months that assessed competencies and problem-solving abilities to deal with fever, infection, vaccination, and daily situations. Secondary outcomes were fear of disease, anxiety, depression, and arthritis helplessness. A total of 120 patients with rheumatoid arthritis and spondyloarthritis were included (60 in each arm) from 7 French rheumatology departments; 99 patients completed the study at 6months and 83 at 12months. The BioSecure score improved at 6months in both arms (delta from baseline 14.9 ± 16.3 in face-to-face education and 16.0 ± 17.9 in combined education) and was maintained for 12months but no significant difference was found between arms at 6 and 12months (p = 0.35 and p = 0.13, respectively). Fear of disease, arthritis helplessness, and anxiety were improved at 6 and 12months with no difference between arms. Educating patients using individual nurse-led sessions or a combination of individual and group sessions increased their safety skills on biologics, with no superiority shown for the combined format. Given the time and resources required to educate patients, these results could lead to potential cost savings. Clinical Trials: NCT03838939. Key Points • Face-to-face patient education has been shown effective in promoting safety skills of patients treated with biologics compared to information provided by the rheumatologist in usual care. • This randomised controlled trial showed that a patient education format combining one individual and one group session was not superior to two individual sessions regarding safety skills assessed at 6 and 12months • Safety skills, fear of disease, arthritis helplessness, and anxiety were improved in both arms. • As the most common barriers to the implementation of patient education are constraints in time and resources, these results could lead to potential cost savings.

Improving the quality of psychiatric residency training in Isfahan University of Medical Sciences by learning teams and changing curriculum implementation: An action research study

BACKGROUND: The deficiencies in the training of psychiatric residents in Isfahan, including the segregation of residency programs by year, the confinement of training to hospital departments, and the residents’ limited exposure to the perspectives of other faculty members, had not been given significant attention. However, the inevitable alterations in the Department of Psychiatry and the impact of the coronavirus disease 2019 pandemic have brought these issues to the forefront, highlighting the need for program modifications. The objective of this study is to enhance the quality of psychiatric residency training by changing the implementation of the curriculum. METHODS AND MATERIALS: This proactive action research was conducted in six steps. In the first step, the expectations of a new action were identified. In the second step, the new action – creating learning teams – was designed and implemented; thus, eight learning teams comprising experienced professors, novice professors, and residents from various academic levels were created, who collectively engaged in patient visits, psychotherapy, counseling, and educational sessions. Additionally, the portfolio was used in the training and evaluation of the residents. Steps 3 to 6 involved evaluation using a researcher-made questionnaire, analysis and interpretation of results, and reflection and making decisions for future actions. RESULTS: Step 1 resulted in preparing a list of department expectations from new action. The second step yielded the design of a new action. The survey results showed that more than 60% of respondents agreed that the program had a positive impact on 12 out of 15 items in the questionnaire, particularly in enhancing teamwork skills, facilitating discussions about patients, and fostering residents’ accountability. However, in items related to portfolio, this percentage ranged from 40% to 53%. CONCLUSION: The implementation of learning teams as the main action in the current study has yielded positive outcomes; however, the portfolio intervention requires some adjustments. Hence, it is advisable to employ learning teams in comparable circumstances. The research team anticipates that these outcomes will enhance the quality of psychiatric residency training, positioning the country among the leading and influential nations in the region.

Delivering a pre-systemic anticancer therapy patient education session

Delivering a pre-systemic anticancer therapy patient education session

Impact of Patient Education on Establishing Trust as the Medical Student Provider: A Student Run Free Clinic Experience

Background: Effective doctor-patient relationships are crucial for quality healthcare, and trust is central to this dynamic. Trust in healthcare comprises competence, empathy, communication, and shared decision-making. Patient education sessions offer a platform to enhance patient trust, especially amongst novice providers. This study investigates the impact of patient education sessions led by medical students on patient trust within the context of a student-run free clinic. Methods: At our student-run free clinic, we conducted a cross-sectional survey to collect patient data, including background information, trust in healthcare, and opinions on education sessions at a student-run free clinic. Results: Amongst the enrolled 24 participants, the demographics revealed a diverse racial composition, with a significant portion having not completed high school and the majority being either unemployed or on disability. Following attendance at patient education sessions, a high percentage of participants reported positive experiences, including improved rapport with medical student providers and a likelihood of returning for future services and following medication recommendations. Conclusion: This study highlights the significant role of patient education sessions in fostering trust between patients and providers, improving health behaviors, and enhancing the broader healthcare system's credibility. It demonstrates how such sessions empower patients, leading to better medication adherence and timely medical assistance seeking, while also suggesting their potential for implementation across various healthcare settings to improve patient engagement and healthcare services.

#2737 “The right choice for you.” How descriptions of treatment options in information resources may influence patient understanding and decision-making

Abstract Background and Aims For people over the age of 65 with comorbidities and/or poor performance status, and for patients over the age of 80, the choice between receiving conservative kidney management (CKM) or receiving dialysis can be complex, and involves weighing possible benefits, risks and effects on quality and length of life. Patients often rely on information resources from renal units, to support their decision-making. We describe how information resources present living with and dying of kidney disease in relation to CKM, haemodialysis and peritoneal dialysis, and consider implications for patients’ treatment decision making. Method Information resources were collected between June 2021 and January 2023 from four UK renal units with varying CKM treatment rates, as part of the OSCAR study (Optimising Staff-Patient Communication in Advanced Renal Disease). Physical and digital copies of information resources were collected from outpatient waiting areas, consultation rooms, and group patient education sessions. We included resources which focused on the treatment options of CKM, haemodialysis, peritoneal dialysis and transplant. Documents were categorised as: Direct Treatment Option Information Resources, focusing specifically on treatment options, either individually or in comparison (category A); Indirect Information Resources, focusing on broader contextual information related to treatment options, such as lifestyle, holiday and diet guidance, and the logistics of receiving treatment, e.g. transport (category B). Document analysis of the information resources was conducted, informed by critical discourse analysis. We examined how documents describe and explain living and dying with kidney failure in relation to treatment options, and how treatment options were placed in context, identifying themes, ‘frames’ and discourse. Results 72 resources were identified across the four renal units, with 46 documents included after deduplication and screening (Fig. 1). Analysis identified three global themes (see Table 1 for illustrative data extracts): Conclusion UK information resources typically present unbalanced explanations of dialysis and CKM, and equate CKM with death and dying. Despite the focus on patients’ “right” to choose a treatment option, it may therefore be challenging for a patient to choose CKM, even when this treatment choice is the best fit for their goals and values. Furthermore, for patients who choose dialysis, information resources often exclude important end-of-life information, limiting their opportunity to consider and participate in advance care planning.

E004 Question of the month; a simple method of patient engagement

Abstract Background/Aims Patient involvement at every stage of service development is key to driving forward meaningful change. It can however, be difficult to engage a broad demographic. Focus groups can gain in depth information but are time consuming and will only involve a small number of people. Questionnaires are often poorly completed or have a low return rate. Asking a ‘question of the month’ is a simple method of collecting a large amount of data on a single topic. We have recently reinstated patient education sessions following a break in their provision due to Covid-19 and were keen to optimise these by finding out what patients wanted. Methods A poster was place in the waiting room asking ‘What was the most useful information you were given when you were diagnosed with arthritis’. Patients were given a post-it note and asked to write an answer on it and stick it onto the poster. The same question was asked in paediatric, adolescent and general adult clinics to all follow up patients with inflammatory arthritis during September 2023. The question of the month concept was developed by the Rubis QI Team as part of the JIALearn project. Thematic analysis was performed for the three age groups separately. Results Themes common to all age groups: 1. Knowing that there are a range of effective treatment options available. 2. Hope: “it is not life changing”, “expect a long journey and try and remain positive” In paediatrics, effective, accessible communication was a dominant theme in “any concerns are important and are listened to” In adolescents and young adults being given hope and knowing that there were treatment options were the most dominant themes: “it doesn’t have to affect your life”, “knowing I had different choices out there to help me” In adults the most dominant theme was around self management, particularly around regular exercise, diet and weight loss. “I can manage my problem”, “allows you to stay in control”. Some patients used this project as an opportunity to leave positive feedback about their care to date. Clinicians involved reported good clinical engagement and an improved therapeutic relationship with patients. These themes will be used to guide future patient education sessions targeted at specific age groups. The results of this project will be developed into a poster for the waiting room to demonstrate that comments have been listened to and acted upon. Conclusion Adults newly diagnosed with arthritis place a strong emphasis on self management. The themes of open communication and hope emerged in children and young adults. The comments provided will help to guide and shape future patient education sessions. Question of the month is a simple way of engaging with a broad number of patients. Disclosure R. Waller: None.

Effectiveness of Community Education for Breast Cancer Screening.

Screening based on individual risk factors results in detection of earlier, more curable breast cancer. There is expectation that improved public education about the importance of personalized screening will result in earlier diagnoses and reduced breast cancer mortality. The purpose of this study is to evaluate the effectiveness of community education on patient perceptions about risk-based screening. This study is Health Insurance Portability and Accountability Act-compliant and institutional review board exempt. A standardized curriculum was used by radiologists and experts to conduct nine 1-hour patient education sessions between October 2018 and January 2019 about breast cancer risk factors and screening options. Patient participants completed voluntary, anonymous pre-event and post event surveys to determine if the presented educational program led to attitude changes. Survey results were summarized using statistical analysis including mean, median, range, and percentage of participants responding and comparison of pre- and post event fear and anxiety. Of 336 education session participants, 59.5% (200/336) completed the pre-event and 44.3% (149/336) completed the post event surveys, Respondents reported decreased anxiety and fear regarding breast cancer screening following educational sessions, with 36.1% (64/178) reporting anxiety pre-event compared to 23.3% (31/133) post event, although the difference was not statistically significant (P = .96). Additionally, 64.7% (55/85) of participants stated they were more likely to schedule breast cancer screening based on individual risk factors, and 98.0% (145/148) of participants reported increased knowledge on post event surveys. This study demonstrates the importance and effectiveness of community-based educational programs in increasing knowledge of risk-based screening and potentially reducing anxiety related to screening.

Patient education teleconsultations for inflammatory rheumatic disease: an opinion survey

Introduction: The recent context of the pandemic has increased the use of telemedicine including patient education (PE) session. We surveyed the opinion of our patients regarding the establishment of PE via teleconsultation. Methods: Retrospective, descriptive, cohort study of patients followed for inflammatory rheumatic disease and seen at least once in a face-to-face (F2F) PE session from 2019 to 2020. Demographic data were extracted from the medical file. We asked participants about their satisfaction on F2F PE sessions and their opinion of PE teleconsultation. Results: We included 186 participants; 143 (77%) were very satisfied with the face-to-face PE sessions. For participants who mentioned restrictions in attending these sessions (n = 72; 39%), the main problems seemed to be geographical isolation (n = 54; 75%) and scheduling issues (n = 9; 12%). Concerning the first F2F PE session, 77/186 (41%) participants would have preferred teleconsultation, potentially in their pharmacy. Regarding an optional collective PE, 81/186 (44%) would rather have had a teleconsultation session. Conclusion: Our study confirms that patients are interested in PE teleconsultation sessions which could lead to lower geographical isolation and scheduling concerns. They would also help reduce health costs and inequalities, including access to medical care in some areas.

Improvement in Diabetic Patient’s Compliance: A Clinical Audit in Accordance with NICE Guidelines

Management of diabetes mainly depends on adherence to the prescribed medicine; however, majority of patients fails to cope with their diabetes management plans due to reasons such as high cost of medication, their side effects, and limited knowledge or understanding of the disease. Medication adherence was accessed in this audit among diabetic patients at the Outpatient department (OPD), Divisional Headquarters (DHQ) Teaching Hospital Mirpur, Azad Jammu and Kashmir (AJK), Pakistan, which focuses on alignment with National Institute for Health and Care Excellence (NICE) guidelines. Adherence was evaluated using a collection of the combination of prospective and retrospective data, through investigation from the patients and review of the records. On 2nd cycle of follow-up, a marked improvement in patients’ adherence to medication, HBA1c levels, smoking cessation and complication rate. Upon 2nd cycle of audit, study also showed a better control on reason of non-compliance to treatment. The cause for non-compliance due to cost issue and lack of understanding was 45% initially, that later shortened to 1% while due to forgetfulness, it also lessened to 1%. We also had a sufficient improvement in follow up visits and sugar monitoring of patients and overall adherence rate was improved. Significant gaps were revealed in the findings by comparing with NICE guidelines, which give emphasis on regular monitoring and focused care of patients. This audit recommends interventions such as education sessions for patients, consultations through tele consults, and regular medical reviews to improve adherence and optimize diabetic care outcomes.

Assessing and Preparing Patients for Hematopoietic Stem Cell Transplant in Canada: An Environmental Scan of Psychosocial Care.

HCT programs across Canada were contacted with a list of questions about their psychosocial assessment and preparation process with patients and caregivers. They could respond via email or participate in an interview over the phone. Descriptive qualitative content analysis was conducted, using steps outlined by Vaismoradi and colleagues (2013). Most participants were social workers from hospitals (64%). Four qualitative themes arose: (a) Psychosocial Team Composition. Psychosocial assessment for HCT patients was often provided by social workers, with limited availability of psychologists and psychiatrists. (b) Criteria for assessing select HCT patients. Participants prioritized psychosocial assessments for patients with higher perceived psychosocial needs or risk, and/or according to transplant type. Limited time and high psychosocial staff demands also played into decision-making. (c) Components and Practices of Pre-HCT Psychosocial Assessment. Common components and differences of assessments were identified, as well as a lack of standardized tools. (d) Patient Education Sessions. Many sites provided adjunct patient education sessions, of varying depth. Significant variation exists in the way programs across the country assess their patients' psychosocial pre-transplant needs and assist in preparing patients for the psychosocial aspects of HCT. This environmental scan identified several strategies used in diverse ways. Further in-depth research on program outcomes across Canada could help to identify which strategies are the most successful.

Two Arm Single-blind Parallel Randomized Controlled Trial Effects of Health Education Intervention on Foot Self-care Behavior Among Diabetic Patients: Study Protocol

Introduction: Diabetes is a chronic illness and it has a significant impact on health. Behavioral interventions theory could improve self-care practices of the foot among patients with diabetic. Behavioral interventions could prevent the risk of foot problems. This trial aims at determining the effect of patient education intervention on foot self-care behavior and clinical outcomes among diabetes patients. Methods: The study is a two-arm single-blinded randomized controlled trial which will be conducted in the Federal Medical Centre (FMC) Owerri, Imo state, Nigeria involving 160 diabetic patients. A central computer-generated randomization list will be generated. Sequentially numbered sealed opaque envelopes will be used to determine concealment. The sample size is 160; therefore 80 participants will receive three sessions of patient education in addition to usual care (intervention group) for three and six months while another 80 participants (control group) will receive only usual care and will receive health education after the study is completed. The outcome of the intervention effectiveness is measured by modified version of Diabetes foot Self-Care Behavior Scale (DFSBS). Discussion: Our hypothesis is that based on the Health Belief Model, patient education intervention can improve foot self-care behavior in the intervention group. Data collection will be done at baseline, and at three- and six-months post intervention. Trial Registration: The Clinical Trials Registry- India (CTRI), Reference no CTRI/2021/06/034311.

Survey of adolescents’ needs and parents’ views on sexual health in juvenile idiopathic arthritis

BackgroundAlthough the advent of new therapeutics for juvenile idiopathic arthritis (JIA) patients has considerably lessened the impact of the disease and reduced its sequelae, the outcomes of JIA remain important in their lives. Disease repercussions and side effects of treatments may affect sexual health and cause psychological distress. This aim of the study was to determine the expectations of adolescent JIA patients and the perceptions of their parents regarding knowledge and communication with healthcare providers (HCPs) in the field of sexual health (SH).MethodsIn France, from September 2021 to April 2022, a survey was conducted, using anonymous self-administered questionnaires, among JIA patients (adults (aged 18–45 years) to provide insights from their recollection of their adolescence) and their parents in nine rheumatology centers and three patient associations.ResultsThe responses to the 76 patient questionnaires and 43 parent questionnaires that were collected were analyzed. Half of the patients thought JIA impacted their romantic relationships, but the results were less clear-cut for their sexual activity; and 58.7% of the patients said they would be comfortable discussing the subject with HCPs, but only 26.3% had done so, mainly regarding biomedical issues. The patients and their parents thought that ideally, the topic should be addressed in an individual patient education session at the hospital (51.3% and 34.9%, respectively), in a regular consultation (47.4% and 53.5%), or in a dedicated consultation requested by the adolescent without the adolescent’s parents being informed (38.2% and 20.9%). Most of the respondents thought HCPs should be proactive in SH (77.6% of the patients and 69.8% of their parents). More patients than parents said the following digital information tools must be used: videos (29.0% vs. 9.3%, p = 0.0127) and smartphone applications (25.0% vs. 9.3%, p = 0.0372).ConclusionHCPs should consider addressing the unmet need for SH discussions during their patient encounters. To meet this need, we propose concrete actions in line with the wishes of patients and parents.Clinical trial registration numberNCT04791189.

Current status of outpatient heart failure management in Egypt and recommendations for the future.

Heart failure (HF) represents one of the greatest healthcare burdens worldwide, and Egypt is no exception. HF healthcare programmes in Egypt still require further optimization to enhance diagnosis and management of the disease. Development of specialized HF clinics (HFCs) and their incorporation in the healthcare system is expected to reduce HF hospitalization and mortality rates and improve quality of care in Egypt. We conducted a literature search on PubMed on the requirements and essential infrastructure of HFCs. Retrieved articles deemed relevant were discussed by a panel of 10 expert cardiologists from Egypt and a basic HFC model for the Egyptian settings was proposed. A multidisciplinary team managing the HFC should essentially be composed of specialized HF cardiologists and nurses, clinical pharmacists, registered nutritionists, physiotherapists, and psychologists. Other clinical specialists should be included according to patients' needs and size and structure of individual clinics. HFCs should receive patients referred from primary care settings, emergency care units, and physicians from different specialties. A basic HFC should have the following fundamental investigations available: resting electrocardiogram, basic transthoracic echocardiogram, and testing for N-terminal pro-B-type natriuretic peptide. Fundamental patients' functional assessments are assessing the New York Heart Association functional classification and quality of life and conducting the 6min walking test. guideline-directed medical therapy should be implemented, and device therapy should be utilized when available. In the first visit, once HF is diagnosed and co-morbidities assessed, guideline-directed medical therapy should be started immediately. Comprehensive patient education sessions should be delivered by HF nurses or clinical pharmacists. The follow-up visit should be scheduled during the initial visit rather than over the phone, and time from the initial visit to the first follow-up visit should be determined based on the patient's health status and needs. Home and virtual visits are only recommended in limited and emergency situations. In this paper, we provide a practical and detailed review on the essential components of HFCs and propose a preliminary model of HFCs as part of a comprehensive HF programme model in Egypt. We believe that other low-to-middle income countries could also benefit from our proposed model.

Organizational Readiness to Implement Community Pharmacy-Based Opioid Counseling and Naloxone Services: A Scoping Review of Current Practice Models and Opportunities

The purpose of this study was to explore existing practice models and opportunities surrounding community pharmacist-delivered opioid counseling and naloxone (OCN) services in the U.S., with the goal of enhancing organizational readiness and improving patient access. A scoping literature review was conducted. English-language articles published in peer-reviewed journals from January 2012–July 2022 were sought via PubMed, CINAHL, IPA, and Google Scholar using permutations of terms such as “pharmacist/pharmacy”, “opioid/opiate”, “naloxone”, “counseling”, and “implement/implementation”. Original articles reporting the resources/inputs (personnel; pharmacist full-time equivalents; facilities and expenses; in-house versus outsourced personnel), implementation processes (legal source of pharmacist authority; patient identification strategies; intervention procedures; workflow strategies; business operations), and programmatic outcomes (uptake and delivery; interventions made; economic impact; patient or provider satisfaction) of pharmacist-delivered OCN services in community (retail) settings were retained. Twelve articles describing ten unique studies were included. The studies primarily used quasi-experimental designs and were published from 2017 to 2021. The articles described seven broad program elements/themes: interprofessional collaboration (n = 2); patient education format including one-on-one patient education (n = 12) and group education sessions (n = 1); non-pharmacist provider education (n = 2); pharmacy staff education (n = 8); opioid misuse screening tools (n = 7); naloxone recommendation/dispensing (n = 12); and opioid therapy and pain management (n = 1). Pharmacists screened/counseled 11–2716 patients and provided 11–430 doses of naloxone. Limited implementation costs, patient/provider satisfaction, or economic impact measures were reported. This review may serve as a guide for community pharmacists in implementing OCN services in their own practices. Future studies should clarify OCN program implementation costs, patient/provider satisfaction, and the economic impact.

Efficacy of a Patient Education Session for Cancer Patients Receiving Immunotherapy

ObjectivesOur research questions include: What are gaps in cancer patients’ knowledge about immunotherapy? What is the efficacy of an education session in improving cancer patients’ knowledge about immunotherapy and reducing inappropriate emergency department (ED) visits? Data SourcesFrom July 2020 to September 2021, we invited cancer patients receiving immunotherapy to participate in a one-on-one patient education session and pre-test/post-test surveys. The patient education session included an oral presentation following National Comprehensive Cancer Network guidelines, video on immunotherapy mechanisms of action, and review of written materials and alert cards. The surveys assessed patient knowledge of immunotherapies’ mechanisms of action, adverse effects and their management, and health literacy. Survey data were paired with data abstracted from the electronic health record on patient ED utilization and demographic characteristics. ConclusionBefore the education session, knowledge gaps about immunotherapy included understanding the medical term “itis,” side effects of immunotherapy, and treatment for side effects of immunotherapy. Overall, the education session significantly improved cancer patients’ knowledge about immunotherapy. The education session addressed knowledge gaps by significantly increasing patients’ knowledge of immunotherapy mechanisms of action, recognition of side effects, and ability to define the medical term “itis”. Because our sample had low inappropriate ED utilization, we could not assess the impact of the education session on inappropriate ED utilization. Implications for Nursing PracticeA multicomponent strategy for patient education was effective in improving overall knowledge uptake, especially among patients who initially had the least knowledge. Future studies should continue to explore whether patient education decreases inappropriate ED utilization.

Effects of a Multimodal Transitional Care Intervention in Patients at High Risk of Readmission

Hospital readmissions are frequent, costly, and sometimes preventable. Although these issues have been well publicized and incentives to reduce them introduced, the best interventions for reducing readmissions remain unclear. To evaluate the effects of a multimodal transitional care intervention targeting patients at high risk of hospital readmission on the composite outcome of 30-day unplanned readmission or death. A single-blinded, multicenter randomized clinical trial was conducted from April 2018 to January 2020, with a 30-day follow-up in 4 medium-to-large-sized teaching hospitals in Switzerland. Participants were consecutive patients discharged from general internal medicine wards and at higher risk of unplanned readmission based on their simplified HOSPITAL score (≥4 points). Data were analyzed between April and September 2022. The intervention group underwent systematic medication reconciliation, a 15-minute patient education session with teach-back, a planned first follow-up visit with their primary care physician, and postdischarge follow-up telephone calls from the study team at 3 and 14 days. The control group received usual care from their hospitalist, plus a 1-page standard study information sheet. Thirty-day postdischarge unplanned readmission or death. A total of 1386 patients were included with a mean (SD) age of 72 (14) years; 712 (51%) were male. The composite outcome of 30-day unplanned readmission or death was 21% (95% CI, 18% to 24%) in the intervention group and 19% (95% CI, 17% to 22%) in the control group. The intention-to-treat analysis risk difference was 1.7% (95% CI, -2.5% to 5.9%; P = .44). There was no evidence of any intervention effects on time to unplanned readmission or death, postdischarge health care use, patient satisfaction with the quality of their care transition, or readmission costs. In this randomized clinical trial, use of a standardized multimodal care transition intervention targeting higher-risk patients did not significantly decrease the risks of 30-day postdischarge unplanned readmission or death; it demonstrated the difficulties in preventing hospital readmissions, even when multimodal interventions specifically target higher-risk patients. ClinicalTrials.gov Identifier: NCT03496896.

Prognostic Factors for Health Outcomes After Exercise Therapy and Education in Individuals With Knee and Hip Osteoarthritis With or Without Comorbidities: A Study of 37,576 Patients Treated in Primary Care.

To identify prognostic factors for health outcomes following an 8-week supervised exercise therapy and education program for individuals with knee and hip osteoarthritis (OA) alone or with concomitant hypertension, heart or respiratory disease, diabetes mellitus, or depression. We included individuals with knee and/or hip OA from the Good Life With OsteoArthritis in Denmark (GLA:D) program. GLA:D consists of 2 patient education sessions and 12 supervised exercise therapy sessions. Before GLA:D, participants self-reported any comorbidities and were categorized into 8 comorbidity groups. Twenty-one potential prognostic factors (demographic information, clinical data, and performance-based physical function) gathered from participants and clinicians before the program were included. Outcomes were physical function using the 40-meter Fast-Paced Walk Test (FPWT), health-related quality of life using the 5-level EuroQol 5-domain (EQ-5D-5L) index score, and pain intensity using a visual analog scale (VAS; range 0-100) assessed before and immediately after the GLA:D program. Within each comorbidity group, associations of prognostic factors with outcomes were estimated using multivariable linear regression. Data from 35,496 (40-meter FPWT) and 37,576 (EQ-5D-5L and VAS) participants were included in the analyses. Clinically relevant associations were demonstrated between age, self-efficacy, self-rated health, and pain intensity and change in 40-meter FPWT, EQ-5D-5L, or VAS scores across comorbidity groups. Furthermore, anxiety, education, physical function, and smoking were associated with outcomes among subgroups having depression or diabetes mellitus in addition to OA. Age, self-efficacy, self-rated health, and pain intensity may be prognostic of change in health outcomes following an 8-week exercise therapy and patient education program for individuals with OA, irrespective of comorbidities.

Development and Validation of a Self-Administered Questionnaire Measuring Essential Knowledge in Patients With Axial Spondyloarthritis.

To develop and validate a patient knowledge questionnaire regarding axial spondyloarthritis (axSpA). Knowledge considered essential for patients with axSpA was identified through Delphi rounds among rheumatologists, healthcare professionals (HCPs), and patients, then reformulated to develop the knowledge questionnaire. Cross-sectional validation was performed in 14 rheumatology departments to assess internal validity (Kuder-Richardson coefficient), external validity, acceptability, reproducibility (Lin concordance correlation coefficient), and sensitivity to change (knowledge score before vs after patient education sessions and effect size). The Spondyloarthritis Knowledge Questionnaire (SPAKE) is a self-administered 42-item questionnaire with a 32-item short form, both scored 0 to 100, assessing knowledge of disease, comorbidities, pharmacological treatments, nonpharmacological treatments, self-care, and adaptive skills. In the validation study (130 patients; 67 [51.5%] male, mean age 43.5 [SD 12.9] yrs), the mean (SD) score of the long-form questionnaire was 71.6 (15.4), with higher scores (better knowledge) in nonpharmacological treatments and adaptive skills and lower scores in cardiovascular comorbidity and pharmacological treatments. Acceptability was good, with no missing data; the internal validity coefficient was 0.85. Reproducibility was good (0.81, 95% CI 0.72-0.89). SPAKE showed good sensitivity to change; scores were 69.2 (15.3) then 82.7 (14.0) after patient education sessions (Hedges effect size = 0.92, 95% CI 0.52-1.31). SPAKE is a knowledge questionnaire for patients with axSpA, developed with the involvement of HCPs and patients and reflecting current recommendations for the management of axSpA. SPAKE will be useful in assessing knowledge acquisition and self-management strategies in routine care and research.

MO927: The Impact of Medication Therapy Management on Medication Burden Quality of Life Among Haemodialysis Patients in Egypt: An Intervention Study

Abstract BACKGROUND AND AIMS End-stage kidney disease (ESKD) is a rapidly increasing global health burden. Renal replacement therapy is essential to save the lives of ESKD patients and is done either through kidney transplantation, peritoneal dialysis or hemodialysis (HD). Patients on HD are subjected to polypharmacy, increase in drug-related problems (DRPs), adverse effects, impaired drug adherence and consequently poor medication burden quality of life (MBQoL). Medication therapy management (MTM) plays an essential role in resolving those problems. The MTM involves performing a medication review, selecting, modifying or administering medication therapy, evaluating the patient’s response to therapy, identifying and resolving any DRPs and providing patient education to enhance the patient’s understanding and adherence to the treatment plan. These pharmaceutical services have shown a positive impact on dialysis patients regarding the economic, humanistic and clinical aspects. We therefore aimed to evaluate the impact of the application of MTM on MBQoL and determine its predictors. METHOD We collected baseline data (sociodemographic, clinical, hemodialysis vintage, hospital admission, drug adverse effects and laboratory) in a pre–post one-group intervention study from all adults on regular maintenance dialysis for >3 months at Alexandria University Hospital. The MBQoL was assessed using the patient-reported outcomes measure of the pharmaceutical therapy (PROMPT) questionnaire after being translated and validated into Arabic. Data on drug adherence was collected by comparing prescribed doses to the actually administered by patients. A structured checklist instrument was used to identify adverse effects. The MTM intervention was applied (medication therapy review, developing a personalized medication record, participating in the medication-related action plan, and patient education sessions). All haemodialysis patients were re-assessed after 3 months. Construct validity was assessed using exploratory factor analysis and reliability was determined using Cronbach's alpha and intraclass correlation coefficient (ICC). Multiple linear regression was used to determine the predictors of the post-MBQoL and change in MBQoL from pre- to post MTM after adjusting for variables with P < 0.10 in bivariate analysis. RESULTS The study included 130 patients who were on average 52 year old (±13), 53.1% were males, 25.8% were smokers, 64.6% had cardiovascular diseases, 26.9% had hepatitis C virus and 14.6% were diabetics. The median (interquartile range) of the dialysis vintage was 5 (2–15) years. The validation of the PROMPT questionnaire was done on an additional 80 haemodialysis patients with similar baseline criteria as the study sample. Exploratory factor analysis revealed that items of the PROMPT were distributed on five domains. Cronbach's alpha was >0.70 for all domains except for ‘impact on patient's life’ (0.52). The ICC was significant (P < 0.01) for all items of the PROMPT questionnaire. The application of MTM had significant effects on the overall PROMPT score (50.74 ± 9.68 versus 59.3 ± 9.86; P < .001), the total number of DRPs (1245 versus 794; P < .001), and calcium level in mg/dL (9.13 ± 0.95 versus 8.77 ± 1.05; P = 0.002). There was a statistically significant reduction in the reported proportion of dry mouth, change of appetite, nausea and vomiting, stomach pain and dyspepsia, diarrhea, constipation and flatulence (P < 0.05). Calcium level (mg/dL) was significantly declined after the MTM application (9.13 ± 0.95 versus 8.77 ± 1.05; P = 0.002). The total number of DRPs was the only significant predictor for change in MBQoL, while university graduates and the a total number of DRPs were the predictors for the post-score of MBQoL. CONCLUSION There is a potentially relevant impact of MTM provision by a clinical pharmacist on medication burden, quality of life, drug-related problems and adverse events among haemodialysis patients.

Impact of psycho-educational therapy on disease activity, quality of life, psychological status, treatment satisfaction and adherence in systemic lupus erythematosus patients

Aim of the workTo evaluate the impact of group psychotherapy and patient education on disease activity, quality of life, psychological symptoms, perceived stress, satisfaction to treatment, and medication adherence in systemic lupus erythematosus (SLE) patients. Patients and methodsThis study recruited 80 SLE patients divided equally into intervention and control groups, the intervention group received 12 sessions of group psychotherapy and patient education. SLE disease activity index (SLEDAI) was assessed. The following questionnaires were conducted: Symptom Checklist-90-Revised (SCL-90-R), perceived stress scale (PSS), Short Form 36 (SF36), Treatment Satisfaction Questionnaire for Medications (TSQM), and Medication Adherence Rating Scale-5 (MARS-5). ResultsThe mean age of the patients was 32.3 ± 7.4 years and disease duration 7.5 ± 5.7 years. They were 77 females and 3 males. At baseline, the SLEDAI, global severity index of SCL-90-R, PSS, SF36, TSQM and MARS-5 were comparable between both groups. After 3 months of the psycho-educational program, the intervention group exhibited significant improvement of SCL-90-R: anxiety (p = 0.052), depression (p = 0.002), global severity index (p = 0.001), PSS (p < 0.001), SF36 [limitations due to emotional problem (p < 0.001), emotional well-being (p < 0.001), MCS (p = 0.029), PCS (p = 0.001)], TSQM [effectiveness (p < 0.001), convenience (p = 0.026), side effects (p = 0.001), global satisfaction (p = 0.005) scores] and MARS-5 (p < 0.001) with no significant difference in SLEDAI (p = 0.802). ConclusionIntegration of a psycho-educational program in the management of SLE patients was associated with improvement of depression, anxiety, perceived stress, quality of life, satisfaction with treatment, and medication adherence, with no impact on disease activity.