Background/Purpose

Primary care providers (physiotherapists, occupational therapists, nurses, family physicians) are often challenged with accessing relevant up-to-date arthritis information to enable delivery of optimal care.  An online arthritis continuing health education program to disseminate arthritis clinical practice guidelines was developed, piloted, and evaluated to address this issue.

Methods

Online learning modules were developed for Osteoarthritis (OA) and Rheumatoid Arthritis (RA) based on published guidelines adapted for primary care (best practices), input from subject matter experts, and a needs assessment.  The program was piloted in two rural/remote areas with high arthritis prevalence and health human resource shortages. Evaluation included 1) paired samples analyses of pre/post measurements of best practice recommendations and confidence and satisfaction with ability to manage arthritis, 2) evaluation of module content and design. Knowledge of best practice guidelines was measured by assigning one point for each best practice applied to a hypothetical case scenario and then summing the points into a total best practice score.  Confidence and satisfaction were measured on 10 point numerical rating scales (0=not satisfied/not at all confident; 10=extremely satisfied/confident).

Results

Primary care providers that completed the modules (OA n=34; RA n=32) demonstrated significant improvements in best practice scores (OA pre=2.8/10, post=3.8/10, p<0.01; RA pre=3.9/12, post=4.6/12, p<0.01). More providers recommended occupational therapy/joint protection for the OA case scenario (pre=32.4%, post=58.8%, p=0.01) after taking the module and more providers recommended patient education for the RA case scenario (pre=46.9%, post=68.8%, p=0.04). Satisfaction with ability to manage arthritis also improved (OA pre=7.0, post=8.0, p<0.01; RA pre=6.0, post=7.0, p<0.01).  Significant increases in confidence with different aspects of arthritis care were also observed (p<0.05).  After taking the OA module, participants’ confidence improved for the comprehensive musculoskeletal examination, prescribing/recommending corticosteroids, ordering/recommending serological tests, and managing common musculoskeletal conditions.  After taking the RA module, participants’ confidence improved for prescribing/recommending joint injections of the knee, DMARDs, and corticosteroids, and managing common musculoskeletal conditions.  Most respondents agreed that the modules were consistent with stated objectives (OA=97.5%; RA=97.1%), addressed learning needs (OA=87.2%; RA=94.3%) and were relevant to practice (OA=80.0%; RA=91.4%). The planned use of relevant resources in practice and with patients highlighted the participants’ commitment to change.  

Conclusion

With knowledge gained from the online modules, participants were able to apply a greater number of best practices and they reported an increase in both satisfaction and confidence with managing arthritis.  The modules were also relevant to practice and the content addressed their learning needs. As a result of the success of the pilot evaluation, both modules were accredited and launched nationally at the end of February 2014.

---

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/getting-a-grip-on-arthritis-online-web-based-continuing-education-supports-the-dissemination-of-arthritis-clinical-practice-guidelines-among-ruralremote-primary-care-providers/