Quality statement 3: Patient education

Quality statement

Adults with rheumatoid arthritis are given opportunities throughout the course of their disease to take part in educational activities that support self-management. [2013, updated 2020]

Rationale

It is important that adults with rheumatoid arthritis are involved in making decisions about their care and have a good understanding of their condition and its management. This enables them to get the best from their medicines, to better manage flare-ups, pain and fatigue, as well as improving their overall quality of life. To ensure they get the greatest benefit, it is essential that adults with rheumatoid arthritis are offered educational and self-management activities and signposting to resources provided by patient organisations, throughout the disease course and at times to suit individual needs.

Quality measures

Structure

Evidence of availability of educational activities for people with rheumatoid arthritis throughout the course of their disease.

Data source: Local data collection, for example, service protocols and treatment plans, or evidence of signposting to patient organisations documented in patient record.

Process

a) Proportion of adults with rheumatoid arthritis who are offered educational activities within 1 month of diagnosis.

Numerator – the number in the denominator who are offered educational activities within 1 month of diagnosis.

Denominator – the number of adults with rheumatoid arthritis.

Data source: Local data collection, for example, documentation in patient records or survey of adults with rheumatoid arthritis. The 2019/20 National Tariff Payment System collects data on adults with rheumatoid arthritis and early inflammatory arthritis who are offered education within 1 month of diagnosis.

b) Proportion of adults with rheumatoid arthritis who report at annual review that they have been given as much information as they want about their condition and its management.

Numerator – the number in the denominator who report that they have been given as much information as they want about their condition and its management.

Denominator – the number of adults with rheumatoid arthritis having an annual review.

Data source: Local data collection, for example, survey of adults with rheumatoid arthritis using the Commissioning for Quality in Rheumatoid Arthritis PREMS for RA: patient questionnaire, sections 1 and 3.

Outcome

Proportion of adults with rheumatoid arthritis who are satisfied with their ability to self-manage their condition.

Numerator – the number in the denominator who are satisfied with their ability to self-manage their condition.

Denominator – the number of adults with rheumatoid arthritis.

Data source: Local data collection, for example, using patient surveys.

What the quality statement means for different audiences

Service providers (such as rheumatology services) ensure that adults with rheumatoid arthritis are offered educational and self-management activities throughout their disease course. They ensure that staff have access to and knowledge of educational materials, structured programmes, and patient organisations for rheumatoid arthritis, and know how to communicate effectively with adults with rheumatoid arthritis to allow for shared decision making.

Healthcare professionals (such as rheumatology consultants, specialist nurses, and allied health professionals) offer adults with rheumatoid arthritis structured educational and self-management activities throughout the course of the disease. They offer verbal and written information at each appointment to improve the person's understanding of their condition and its management. They provide opportunities for adults with rheumatoid arthritis to be involved in decisions on management of their disease and they signpost to relevant patient organisations.

Commissioners (such as clinical commissioning groups) commission services that provide educational and self-management activities for adults with rheumatoid arthritis and engage with patient organisations to provide additional support and resources.

Adults with rheumatoid arthritis take part in activities that help them to learn about their condition and what they can do to help themselves (self-management). These activities and resources should be available throughout the course of their disease. They are offered information to help them make decisions on managing their condition.

Source guidance

Definitions of terms used in this quality statement

Educational activities

Educational activities and self-management programmes can be provided 1-to-1 in a clinic setting, through self-study or computer-based interventions. They can also be provided in formal organised group sessions led by rheumatology healthcare professionals or trained lay leaders with arthritis or other chronic conditions. Different formats may be used, and should include patient information supported by written resources, to improve understanding of the condition and its management, and counter any misconceptions adults with rheumatoid arthritis may have. Educational activities may include lectures or facilitated interactive group discussions to increase knowledge and reduce concerns. Alternatively, regular skills practice, goal setting and home programmes may be used to facilitate behavioural change. The opportunity to take part in existing educational activities and self-management programmes should be offered to adults with rheumatoid arthritis throughout the course of their disease.

[Adapted from NICE's full guideline on rheumatoid arthritis in adults, section 5.2]

Equality and diversity considerations

Adults with rheumatoid arthritis should be provided with education and self-management materials and resources that they can easily read and understand themselves, or with support. Information should be in a format that suits their needs and preferences. It should be accessible to people who do not speak or read English, and it should be culturally and age appropriate. Adults with rheumatoid arthritis should have access to an interpreter or advocate if needed.

For people with additional needs related to a disability, impairment or sensory loss, information should be provided as set out in NHS England's Accessible Information Standard.

Adults with rheumatoid arthritis should be offered information about planning a pregnancy, pregnancy and breastfeeding at the time of diagnosis and throughout the course of their disease. The information should be appropriate to their age and circumstances.