Background/Purpose:

To compare the effect of standard nurse led methotrexate self-injection patient education to a methotrexate self-injection web based education video added to standard teaching on 1) Patient satisfaction with teaching 2) Patient self-confidence in performing the injection 3) Patient knowledge around injection technique & precautions & 4) nursing time required.

Methods: Consecutive rheumatology patients at the University of Alberta Medicine Clinic seen by the Clinic Nurse for methotrexate self-injection education were asked to participate in the study.  Each patient’s pre-education confidence for self-injection (Visual Analog Scale 1-10), age, gender, & education level was ascertained.  Patients were randomized 1:1 to either standard teaching or the intervention: a 12 minute video reviewing the steps before, during and after methotrexate self-injection, followed by further in-person nurse education with a focus on reviewing patient concerns and questions arising from the video, and practicing self-injection similar to the non-intervention group.   At the end of the teaching session, patients recorded their post-education confidence for self-injection, their satisfaction with the teaching process (VAS 1-10), and answers to 4 specific knowledge based questions on methotrexate self-injection (graded as a score out of 6).  The nurse recorded the number of minutes spent providing direct education to the patient.

Results:

29 patients participated in this study: 15 had standard (S) teaching and 14 were in the intervention group (VS).  Average age (49), gender (VS= 6 males, S=5), & education level was similar in both groups.  Both groups were very satisfied with the quality of teaching (9.9/10).  There was no difference in pre-confidence (S=5.5/10 vs. VS=4.7/10, p=0.44) or post-confidence (S=8.8, VS=8.8, p=0.93) between the groups, although there was a trend to greater improvement in confidence in the video group (p=0.15).  Further, there was a trend towards improved patient knowledge in the video group vs. the standard group, with an average of more correct answers in the video group (S=4.7/6, VS=5.5/6, p=0.15).  Nurse teaching time was significantly less in the video group compared to the standard group (S=60 minutes, VS=44 minutes, p=0.012).

Conclusion:

A web based education video may be a good supplement to standard in person nurse teaching for methotrexate self-injection.  It has equally as good benefit on patient confidence and knowledge base while decreasing teaching time by 25%.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/implementation-of-a-methotrexate-self-injection-education-video-reducing-teaching-time-while-maintaining-patient-confidence-and-knowledge/