Background/Purpose: Long-term outcomes in rheumatic diseases can be improved by improving patients’ knowledge, beliefs and perception about their disease which can help them in coping with the disease better. However, there is a lack of tools/instruments in rheumatoid arthritis (RA) to 1. objectively assess patients’ knowledge in various domains & 2. To assess the impact of a patient education program. The aim of the study is to develop, validate and assess the performance of a self-prepared questionnaire for assessing patients’ knowledge about their disease and to use this tool to assess the impact of an information course in improving the above-mentioned elements among patient.

Methods: A self-prepared questionnaire (Hindi/English) containing 24 multiple choice or true-false type questions with single correct answer assessing patients’ knowledge about RA in 3 domains (a. etiology, disease process, signs & symptoms b. drug therapy & monitoring c. joint protection, exercise, coping) was prepared. All questions had an item-level content validity index (I-CVI) of at least 0.9. The scale-level content validity index based on the universal agreement method (S-CVI/UA) was 0.8 for the whole questionnaire as assessed by 6 experts. All questions had an option of ‘I don’t know’ which would prevent patients from guessing the answer from the available options. Each question was given a score of 1 if answered correctly. The questionnaire was applied 3 times: at baseline, immediately after an information course to see the immediate impact and after 4 months to see the retention of the information. Information on demographic features and socio-economic status was also collected. Frequency data were compared using McNemar test for paired nominal data & kappa statistics for ordinal data. Student’s paired t-test was used for comparison of mean scores to see the impact.

Results: At baseline, the questionnaire was applied to 274 patients with RA (F:M=248:26; mean age 44±11.9 years) and the median(range) score was poor 5(0-21) (Table–1). Among them, 141 patients attended the information course. The option ‘I don’t know’ was exercised 3186 times (48.24%) before the information course which reduced to 469 (13.86%) times after the course. After the information course, all the questions recorded a higher number of correct responses as compared to before the course. Twenty-one questions had significantly higher correct response rate (Table–1). Median score for increased from 5(0-21) to 17(0-24) (p< 0.001) which was irrespective of the socio-economic classes and education status of the patients (Figure-1). Upon re-administering the questionnaire after 4 months, the median score 13(0-24) of the questionnaire (n=78) remained significantly higher (p< 0.001) as compared to baseline score (Figure 1) with 21 out of 24 questions achieving statistical significance (Table–2).

Conclusion: Indian patients with RA have a poor knowledge base about their disease which one may strive to improve by implementing short information courses. The information course was found to be effective across the socio-economic classes and educational status. The provided information was retained at 4th month of follow up months without any reinforcement course.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/assessment-of-the-immediate-and-short-term-impact-of-an-information-course-on-patients-knowledge-about-rheumatoid-arthritis-evaluation-using-a-self-prepared-and-validated-assessment-questionnaire/