Background/Purpose:  There is a growing body of evidence to support the effectiveness of education programs for patients with arthritis. Despite this, there has been little development or investigation into education strategies specifically for patients with axial spondyloarthritis (axSpA). A number of studies examining education strategies for patients with various forms of arthritis have involved an interdisciplinary approach and suggest positive impact on disease activity, function and overall health. Furthermore, the use of an electronic format for education has been shown to be preferred over other methods of education for patients with axSpA. As such, the Toronto Western Hospital Spondylitis Program developed an interactive web-based e-Learning education module for patients with axSpA with input from patients and an interdisciplinary team of health care professionals and consists of evidence-based topics including diagnosis, treatment and self-management for axSpA. The purpose of this study was to measure the effect of the axSpA e-Learning patient education module with respect to: 1) knowledge of axSpA; 2) chronic disease self-efficacy, and 3) exercise behaviour.

Methods:  Fifty-six adult patients with axSpA attending a tertiary academic spondylitis clinic were randomly assigned to one of two groups: 1) e-Learning intervention, in addition to usual care, where patients were emailed a link to the online patient education module and were asked to complete the module at their leisure; or, 2) usual care (i.e. control group). All patients completed outcome questionnaires at baseline, immediately after the completion of the e-Learning module and at 6-12 months thereafter. Outcome measures included: the Ankylosing Spondylitis (AS): “what do you know” knowledge questionnaire; Stanford Chronic Disease Self-Efficacy Scale, and the Stanford questionnaire for Exercise Behaviours.

Results:  Twenty-three patients with axSpA completed the e-Learning education module, in addition to usual care, and 33 patients continued with usual care. Overall, mean (SD) age was 42.3 (12.9) years, 69.6% were male, mean (SD) disease duration was 12.9 (10.2) years and 75% had a post-secondary education. There were no statistically significant differences in the above outcome measures between the two groups at baseline or immediately following the completion of the e-Learning module. At the 6-12 month follow-up there was an overall increase in the number of minutes dedicated to all types of exercise the week prior to completing the outcome measures in the intervention group compared to controls, with a significant increase in the average minutes dedicated to bicycling as a form of exercise from a mean of 5.2 minutes to 34.6 minutes, p=0.02.

Conclusion: The results of this study demonstrate the addition of the axSpA e-Learning patient education module to usual care is equivalent to usual care provided at a tertiary academic spondylitis clinic and has potential to provide benefit to patients with axSpA who have limited access to specialty care. Long-term results suggest a significant impact on exercise behaviours in patients with axSpA who completed the e-Learning module.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-e-learning-on-knowledge-self-efficacy-and-exercise-behaviours-of-patients-with-axial-spondyloarthritis-results-from-a-longitudinal-randomized-control-trial/