1. EULAR recommendations for patient education for people with inflammatory arthritis

2. Slide 1: Target population/question
Rheumatology health professionals including rheumatologists, patients with inflammatory arthritis, policy makers and patient and professional organisations.
Objectives
to develop a set of recommendations for PE for people with inflammatory arthritis (IA)
to identify the need for further research and
to define HPs’ educational needs for providing evidence-based PE
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3. Slide 2: Methods/methodical approach
The EULAR standardised operation procedures for the elaboration, evaluation, dissemination and implementation of recommendations were followed.1
A multidisciplinary task force including patients, was convened, and led by an epidemiologist, formulated a definition for patient education and 10 research questions
Systematic review was conducted by a research fellow
The results of the systematic review were discussed and used as a basis for developing the recommendations, a research agenda and an educational agenda
The recommendations were categorised according to level and strength of evidence graded from A (highest) to D (lowest).
Task force members rated their agreement with each recommendation from 0 (total disagreement) to 10 (total agreement)
1Dougados M, Betteridge N, Burmester GR, et al. Ann Rheum Dis 2004;63:
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4. Slide 3: Overarching principles
Patient education is a planned interactive learning process designed to support and enable people to manage their life with inflammatory arthritis and optimise their health and well-being
Communication and shared decision making between people with inflammatory arthritis and their healthcare professionals are essential for effective patient education
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5. Slides 5-7: Individual Recommendations
Patient education should be provided for people with inflammatory arthritis as an integral part of standard care in order to increase patient involvement in disease management and health promotion
All people with inflammatory arthritis should have access to and be offered patient education throughout the course of their disease including as a minimum; at diagnosis, at pharmacological treatment change and when required by the patient's physical or psychological condition
The content and delivery of patient education should be individually tailored and needs-based for people with inflammatory arthritis
Patient education in inflammatory arthritis should include individual and/or group sessions, which can be provided through face-to-face or online interactions, and supplemented by phone calls, written or multimedia material
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6. Slides 5-6: Individual Recommendations
Patient education programmes in inflammatory arthritis should have a theoretical framework and be evidence-based, such as self-management, cognitive behavioural therapy or stress management
The effectiveness of patient education in inflammatory arthritis should be evaluated and outcomes used must reflect the objectives of the patient education programme
Patient education in inflammatory arthritis should be delivered by competent health professionals and/or by trained patients, if appropriate, in a multidisciplinary team
Providers of patient education in inflammatory arthritis should have access to and undertake specific training in order to obtain and maintain knowledge and skills
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7. Slide 7: Summary Table Oxford Level of Evidence
Recommendations
Level of evidence
Strength of recommendation
1. Patient education as an integral part of standard care
1A–2B
A–C
2. Patient education throughout the course of the disease
3–4
C–D
3.  Tailored and needs-based patient education 1B A
4.  Modes of delivery of patient education
1A–B
5.  Theoretical framework and evidence for patient education
6. Outcomes of patient education 4 D
7. Competency in delivery of patient education 3 C
8.  Training competency for delivering patient education
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8. Slide 8: Conclusion
Eight evidence-based and expert opinion-based recommendations for patient education for people with inflammatory arthritis have been developed
The recommendations address when and by whom patient educaiton should be offered, modes and methods of delivery, theoretical framework, outcomes and evaluation
The recommendations are intended to provide a core framework for the delivery of patient education and training for health professionals
A high level of agreement was achieved for all recommendations (mean range )
The task force proposed a reearch agenda and an educational agenda
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9. Slide 9: Lay summary of Recommendations
Education for people with inflammatory arthritis
Patient education should be a part of normal care for people with inflammatory arthritis.****
Patient education should be offered more than once.**
The content of patient education should be designed according to the needs for each person.****
Patient education might be given in a variety of different ways.****
Patient education should be based on theory and evidence.****
Patient education should be evaluated.*
Patient education should be delivered by health professionals e.g. doctors, nurses, psychologists, physiotherapists and/or trained patients as part of a team.**
People providing patient education should be trained and maintain their knowledge and skills.**
One star (*) means it is a weak recommendation with limited evidence. Two stars (**) means it is a weak recommendation with some evidence. Three stars (***) means it is a strong recommendation with some evidence. Four stars (****) means it is a strong recommendation with a lot of evidence.
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10. Slide 10: Acknowledgements
Kari Matre (medical librarian, Diakonhjemmet Hospital Library) for providing expertise in search methods.
Contributors of lay summary: Dieter Wiek, Margot Bakkers, Petra Balazova, Fearghal O’Nia, Irene Pitsillidou
European League Against Rheumatism (EULAR) for funding the project. Grant reference: HPR024
Members of the consultation group: Adewale Adebajo, Michael Backhouse, Ulrika Bergsten, Tricia Cornell, Jenny de la Torre-Aboki, Silvia Garcia Diaz, Ricardo Ferreira, Kjersti Gronning, Bernadette Hardware, Agnes Kocher, Marja Leena Kukkurainen, Ingrid Larsson, Azucena Pedraz Marcos, Andrea Marques, Jorit Meesters, Sue Oliver, David Pickles, Birgit Prodinger, Sarah Ryan and Karen Vinall
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