Background/Purpose: Effective patient education provides individuals with essential information about their disease and treatment alternatives, and aids informed decision-making. The purpose of our study was to test the efficacy of a multimedia patient education tool (MM-PtET) including storylines and testimonials for patients with rheumatoid arthritis (RA).

Methods:   Patients were recruited from 5 centers and through advertisement. Inclusion criteria were: (i) age ≥18 years (ii) diagnosis of RA by a rheumatologist (iii) disease duration ≤10 years (iii) adequate cognitive status and, (iv) ability to communicate in English or Spanish language. After completion of a baseline questionnaire, participants reviewed materials of the group to which they Patients were randomized to receive a MM-PtET or a written booklet, both with the same written information. They completed self-report questionnaires before and after viewing the assigned materials. Primary outcome measures included: a) Disease knowledge, and b) Decisional conflict. Secondary outcomes included: a) Acceptability, and b) Educational tool evaluation. We compared differences between and within groups for outcomes of interest. Linear regression was performed to assess the influence of the intervention and patient characteristics on the knowledge score. 

Results:  221 participants were randomized (111=MM-PtET, 110=written booklet). Mean age was 51±13 years, mean disease duration was 5±3 years, 85%were female 24% had inadequate health literacy levels and 41(%) were Spanish speaking. Post randomization, both, intervention and control groups, showed significantly higher knowledge scores (Intervention: 5.5±2.1 vs 7.6±1.5 and, Control: 5.5±2.1 vs 7.1±2.0; p<0.05 for both groups) and, significantly lower “Informed” and “Values clarity” scores (p<0.05 for both scales).  No statistically significant differences was observed between the two groups for knowledge improvement and decisional conflict scales (p>0.10 for both measures). The majority of the participants in both groups gave a favorable response to all evaluation questions, with no significant differences in response options observed between the two groups (p>0.05). Regarding acceptability, MM-PtET group participants were more likely to rate the presentation as “Excellent” for the following items: impact of RA, medication options, evidence about medications, benefits of medication, and self-care options (p<0.05 for all). Also, compared to the control group, more participants in the MM-PtET group found the length of the material presented as “just right” (Intervention vs Control: 92% vs 80%, p=0.03). Regression analysis indicated that, being in MM-PtET group, shorter disease duration and being Hispanic compared to White, was predictive of greater knowledge improvement (p<0.05, Adjusted R²=0.08).

Conclusion:  Viewing of the MM-PtET was as effective and more acceptable than reading written materials in RA patients. Hispanics and patients with shorter disease duration may achieve the greatest benefit from multimedia tools incorporating narratives and stories.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/multimedia-patient-education-tool-for-patients-with-rheumatoid-arthritis/