Gap between short- and long-term effects of patient education in rheumatoid arthritis patients: a systematic review.

OBJECTIVE:

To systematically review educational or psychoeducational interventions for patients with rheumatoid arthritis focusing on long-term effects, especially health status.

METHODS:

Two independent reviewers appraised the methodologic quality of the included randomized controlled trials, published between 1980 and July 2002.

RESULTS:

Validity scores of studies ranged from 3 to 9 (of 11). The 7 educational programs mainly improved knowledge and compliance in the short and long term, but there was no improvement in health status. All 4 psychoeducational programs improved coping behavior in the short term, 2 of them showing a positive long-term effect on physical or psychological health variables.

CONCLUSION:

Methodologically better-designed studies had more difficulties demonstrating positive outcome results. Short-term effects in program targets are generally observed, whereas long-term changes in health status are not convincingly demonstrated. There is a need to find better strategies to enhance the transfer of short-term effects into gains in health status.