Exploring the Learning Needs of Individuals With Inflammatory Arthritis From the Perspectives of Patients, Family Members and Friends, and Health Care Providers Patient Perspectives: Perspectives of Health Care Providers

Abstract

Benefits of medical treatment in patients recently diagnosed with inflammatory arthritis are well documented, but delays in the commencement of these treatment regimens often leads to poor and irreversible healthcare outcomes. This study aims to explore the informational needs and educational preferences of persons with early inflammatory arthritis through the perspective of their health care providers in efforts to expedite the time to treatment. This project is part of a larger multidisciplinary study that also investigates these learning needs from the perspectives of the patients, their families, and their culture. Specifically for this part of the project, healthcare providers who are engaged in work related to inflammatory arthritis care will be invited to participate as key informants. Using a semi-structured interview guide, these participants will provide personal insight from their experiences in working with patients diagnosed with inflammatory arthritis regarding the informational and educational barriers they believe lead to delays in arthritis treatment in Ontario patients.

Rationale Disorders of the musculoskeletal system remain a prevalent cause of long-term disability in Canada and their burden on society and the health care system is projected to continue increasing1-5. There are currently over 4 million Canadians inflicted with arthritis, a figure projected to continue increasing to 6 million by 2026. Although there is currently no cure for this disease, medical intervention has been demonstrated to prevent disability, help maintain function, and reduce arthritis associated pain6.

Although the benefits of commencing early treatment in patients recently diagnosed with inflammatory arthritis are well documented6, delays due to the shortage in the number of qualified healthcare providers trained to meet the demands of this growing disease7-11 often leads to poor and irreversible health outcomes in these patients12-14. This disparity has created gaps in the care of these patients including access to arthritis-related services, specialist and rehabilitation services7,8. To compound this, the stress acquired following a diagnosis of inflammatory arthritis has been shown to greatly impede patients' cognitive function and decision-making abilities. Unlike the disparity in healthcare providers, these patient-related variables, although likely to play a major role in disease progression, are currently not well understood. In light of this, one cost-effective option to shortening the time between disease onset and treatment is to better understand the hurdles patients face following their diagnosis and develop more efficient mechanisms to deliver the information to this group more effectively. By exploring the informational needs and educational preferences of persons with early inflammatory arthritis, the development of such novel strategies will likely be possible.

Promoting patient education in self management encourages self-autonomy and is considered one of the key elements to optimal clinical practice. It increases confidence and self-esteem and empowers patients to be come more independent at coping and managing their arthritis15,16. Furthermore, self-management strategies increase the efficacy of prescribed medication and allow patients play a more active role in the management of their disease with relatively little supervision from healthcare providers17. These ideals are often not met in the clinical setting as a large proportion of patients fail to engage or continue with this independent approach. Such failures may be accounted for by the variable learning stages and individual needs of patients and thus require refinement in order to improve long-term adherence to self-management strategies18,19. Understanding the needs of patients in these different stages of learning will be vital to implement new patient-directed therapies.