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Nurse-led education 'effective' in teaching arthritis patients safety skills

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Self-care guidance from nurses can equip patients with the skills and knowledge they need to manage the risks associated with taking disease-modifying drugs for inflammatory arthritis, according to a landmark study.

The trial, led by researchers from France, proved for the first time that nurse-led patient education is effective in teaching essential safety skills to those prescribed biologic disease-modifying drugs (bDMARDs), which work to slow down progression of arthritis.

“We hope our results provide evidence to support the implementation of nurse-led patient education”

Catherine Beauvais

The study, published in the British Medical Journal, involved 120 people who were diagnosed with rheumatoid arthritis, axial spondyloarthritis or peripheral spondyloarthritis.

The academics highlighted that bDMARDs were highly effective in treating these conditions but they may also bring serious side-effects most notably a risk of infections.

As part of the study, carried out between January 2017 and April 2018, the patients were randomly spilt into two groups.

The “intervention” group received two nurse-led education sessions – one at the beginning of the trial and another three months later – focussed on safety skills, self-injections and motivation. The “usual care” group did not receive any additional nurse education.

After six months, all the participants were tested on their safety skills using the Biosecure Questionnaire, which assesses competences in dealing with risks such as fever, planned surgery, dental care, travel, minor traumas and immunisations, measuring on a scale from 0 to 100.

The results showed the intervention group had significantly higher acquisition of safety skills compared to the usual care group with a Biosecure score of 81.2 versus 75.6, respectively.

The researchers concluded: “In this trial, a nurse-led patient education was shown for the first time to be effective in teaching patients the essential safety skills.”

Catherine Beauvais, one of the study authors from University Hospital Saint Antoine, Paris, said: “Safety is an important issue in the management of inflammatory arthritis treated with biologic disease-modifying antirheumatic drugs.

“We hope our results provide evidence to support the implementation of nurse-led patient education programmes in centres across Europe,” she added.

In addition to safety skills, patients were assessed on “secondary outcomes” including quality of life, severe infections rate, ability to cope and psychological wellbeing.

The results for these secondary outcomes were also found to be “favourable” for the intervention group.

The study findings were also presented last week at the Annual European Congress of Rheumatology (EULAR 2019), held in Madrid, Spain.

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