Background/Purpose: Individuals impacted by arthritis have identified social role participation (e.g. relationships, leisure activities, employment) as an important quality of life outcome. There is evidence that education programs are effective for patients with arthritis in terms of improved function and quality of life. The Toronto Western Hospital Spondyloarthritis Program developed a novel interactive e-Learning education program for patients with axial Spondyloarthritis (axSpA) with input from patients and an interdisciplinary team of health care professionals. The purpose of this study was to measure the impact of the axSpA e-Learning patient education program on patients’ perception of social roles and participation.

Methods:  Fifty-six adult patients with axSpA attending a tertiary academic spondyloarthritis 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 to be completed at their leisure; or, 2) usual care (i.e. control group). All patients completed outcomes measuring Social Role and Participation (SRPQ, Gignac et al. 2011) at baseline, immediately after completing the e-Learning module, and at 6 to 12 months thereafter. The SRPQ includes 12 role domains with 3 dimensions: 1) role importance, 2) restriction to role participation, and 3) satisfaction with social role performance. Univariate and bivariate analyses were conducted on SAS version 9.2.

Results:  Twenty-three patients with axSpA completed the e-Learning module and thirty-three 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. Comparison by study group at baseline showed that importance of “relationship with other family members” was lower in the intervention group compared to controls (p = 0.02). Otherwise there were no significant differences between groups at baseline. Immediate follow-up measures indicated lower perceived importance in the intervention group with respect to: “plan/attend social events” (p = 0.007); “having a paid job” (p = 0.005); “relationship with other family members” (p = 0.02); and “fully participating in all aspects of life” (p = 0.02) The intervention group reported lower satisfaction with “type of paid work that you are able to have” (p = 0.03). Otherwise, no significant differences were noted between control and intervention groups at immediate follow-up. At 6-12 months follow-up, the intervention group reported less physical difficulty “participating in hobbies” (p = 0.04) and “engaging in activities with children/grandchildren” (p = 0.04). In addition the intervention group identified “intimate relationships” (p = 0.02) and “fully participating in all aspects of life” (p = 0.02) as less important.

Conclusion: Although there are significant differences in the levels of importance of several social role subscales, the reported differences are relatively small. Long-term findings of less physical difficulty with some social role subscales indicate potential long-term benefits of the e-Learning module to patients with axSpA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/impact-of-e-learning-on-perceived-social-role-participation-of-patients-with-axial-spondyloarthritis-results-from-a-longitudinal-randomized-control-trial/