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Therapeutic education for patients with rheumatoid arthritis: description of MediPR program Volume 24, issue 4, décembre 2005

Authors
Département de pharmacie, CHU de Grenoble, Service de rhumatologie, CHU de Grenoble

Introduction: the objective of the present work was to construct an educational program applied to a group of 2 to 4 patients affected by rheumatoid arthritis (RA), on the basis of the: 1) definition of a referential of expertise to be acquired by the patient; 2) construction of an adapted educational sequence. Methods: we conducted a bibliographic research (training process, educational methods, existing programs for RA patients). We also achieved non directive interviews with thirteen patients, in order to study their representations of the pathology and the drug treatment. On these two types of elements, we defined our referential on basis of which we constructed an educational sequence. Results: our referential is composed of five objectives associated to a specific educational sequence. The patient should be able to: 1) explain mechanisms of the rheumatoid arthritis (presentation of a picture folder to describe the pathology); 2) differentiate between symptomatic and disease modifying antirheumatic treatments (picture folder; reconstitution of a puzzle to classify the different treatments; sorting of drug containers); 3) treat a painful crisis with symptomatic drugs (round table discussion as means of sharing of experience between patients; analogical device « staircase of the pain » to visualize the different levels of analgesia); 4) manage his/her disease modifying antirheumatic treatment (round table); 5) identify the side effects of a treatment (round table). This program was tested during fifteen sessions of one hour in the setting of a « school of the rheumatoid arthritis » programmed on 3 days. Conclusion: we think about the setting up of individual sessions, complementary of theses group sessions, in order to develop an educational diagnosis and a personalized follow-up of each patient.