Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries

Sarah E. Bennett, Heidi A. Zangi, Ingrid Larsson, Catherine Beauvais, Carina Boström, Andrea Domján, Yvonne Van Eijk-Hustings, Kristien Van Der Elst, Françoise Fayet, Ricardo J.O. Ferreira, Mie Fusama, Mariela Geneva-Popova, María Del Carmen Herrero Manso, Kirsten Hoeper, Bethan Jones, Marja Leena Kukkurainen, Suet Kei Gladys Kwok, Patricia Minnock, Tiziana Nava, Jette PrimdahlRoopa Rawat, Matylda Sierakowska, Michaela Stoffer-Marx, Astrid Van Tubergen, Mwidimi Ndosi*

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objectives: To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. Methods: A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. Results: A total of 1159 completed the survey; 852 (73.5%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery. Conclusions: This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools.

Original languageEnglish
JournalAnnals of the rheumatic diseases
Volume81
Issue number10
Pages (from-to)1348-1357
ISSN0003-4967
DOIs
Publication statusPublished - Oct 2022

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords

  • Arthritis
  • Health services research
  • Patient Care Team
  • Qualitative research
  • Humans
  • Rheumatology
  • Female
  • Male
  • Arthritis/therapy
  • Physical Therapists
  • Rheumatologists
  • Patient Education as Topic

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