Educational readiness among health professionals in rheumatology: low awareness of EULAR offerings and unfamiliarity with the course content as major barriers-results of a EULAR-funded European survey

BACKGROUND

Ongoing education of health professionals in rheumatology (HPR) is critical for high-quality care. An essential factor is education readiness and a high quality of educational offerings. We explored which factors contributed to education readiness and investigated currently offered postgraduate education, including the European Alliance of Associations for Rheumatology (EULAR) offerings.

METHODS AND PARTICIPANTS

We developed an online questionnaire, translated it into 24 languages and distributed it in 30 European countries. We used natural language processing and the Latent Dirichlet Allocation to analyse the qualitative experiences of the participants as well as descriptive statistics and multiple logistic regression to determine factors influencing postgraduate educational readiness. Reporting followed the Checklist for Reporting Results of Internet E-Surveys guideline.

RESULTS

The questionnaire was accessed 3589 times, and 667 complete responses from 34 European countries were recorded. The highest educational needs were 'professional development', 'prevention and lifestyle intervention'. Older age, more working experience in rheumatology and higher education levels were positively associated with higher postgraduate educational readiness. While more than half of the HPR were familiar with EULAR as an association and the respondents reported an increased interest in the content of the educational offerings, the courses and the annual congress were poorly attended due to a lack of awareness, comparatively high costs and language barriers.

CONCLUSIONS

To promote the uptake of EULAR educational offerings, attention is needed to increase awareness among national organisations, offer accessible participation costs, and address language barriers.

POS0360-PARE EDUCATIONAL NEEDS AMONG PATIENTS WITH RHEUMATOID ARTHRITIS AND HEALTH PROFESSIONALS IN RHEUMATOLOGY: A SWISS CROSS-SECTIONAL QUALITATIVE ANALYSIS

Background

The content and delivery of patient education (PE) should be individually tailored and needs-based for people with inflammatory arthritis1. Therefore, a patient trained in PE joined forces with a rheumatology clinical nurse specialist to explore the needs for the management of patients with RA in a Swiss local context (rheumatology department of a university hospital).

Objectives

To identify the difficulties and needs of patients with RA regarding their disease and its management in a local context, from both perspectives: patients and health professionals (HPs).

Methods

We developed 2 different semi-structured questionnaires for each surveyed group. They were distributed to 93 patients and 62 HPs during Summer 2020. Only the fully completed surveys were analysed. A qualitative analysis of the answers to the open questions was carried out and the phenomena thus highlighted were then quantified.

Results

We collected 38 patient (40%) and 35 HP (56%) questionnaires, and 23 patients (25%) and 21 HPs (34%) filled them completely out.

Participants among patients were mostly female (74%) with a mean (SD) age of 54,8 (10,9). Mean (SD) number of years of illness after diagnosis was 11,9 (12,6). HPs were nurses (57,1%), medical doctors (19%), occupational therapists (14,3%), physiotherapists (4,8%) and assistant nurses (4,8%).

Almost half of HPs (48%) and 39% of patients experience difficulties to talk about sensitive topics like sexuality, financial or emotional difficulties.

A third of patients (30%) wished a more supportive attitude from HPs and HPs (62%) would like patients to be more involved in their care, more specifically regarding autonomy and treatment adherence. A few HPs (9%) and patients (19%) want to improve patient-centred and personalised care. Most of HPs (81%) and patients (87%) state that they have no objection or reluctance to PE being developed in the department. Some HPs see PE as an additional workload (19%) and others as a tool to involve the patients more in their care (43%).

HPs (43%) express a need for patient’s and disease’s management training and wish to acquire additional tools and methods to better assist their patients (43%). A third of them (33%) report a lack of communication, collaboration and interdisciplinarity to support patients. Furthermore, due to the lack of time and availability, 67% of them are not able to provide adequate time for meeting the patients’ needs. Some HPs feel powerless to help their patients (19%). Some others (18%) highlight the difference of perspectives and concerns between patients and HPs.

Patients and HPs agreed on most of the main difficulties related to the disease and follow-up. It should be noted that HPs were not aware of the difficulties related to their patients’ sleep. The painful and distressing psychological and emotional impact of RA is the difficulty most cited by patients (74%) and the second most mentioned by HPs. More than half of patients (61%) have difficulty managing their pain.

Conclusion

The results of this study confirm the need for PE in the department. Communication is a challenge for both populations. HPs know their patients well, but patients and HPs have different expectations regarding disease’s management and follow-up. This work shows the importance of analysing educational needs: it brings out dimensions of the disease and its management that are sometimes hidden or underinvestigated. It thus helps to have a better understanding of the reality and difficulties as they are experienced by people in order to propose appropriate solutions. This work provides a basis for reflection and discussion for the future development and implementation of a PE program, based on the paradigm of the patient-HP partnership. In addition to being an example of an advanced and successful patient-HP partnership, it also demonstrates the benefits of such collaboration.

References

[1]Zangi HA, Ndosi M, Adams J, et al. EULAR recommendations for patient education for people with inflammatory arthritis Annals of the Rheumatic Diseases 2015;74:954-962.

Disclosure of Interests

None declared

OP0317 ACCURACY OF THE OMERACT DEFINITIONS FOR IDENTIFICATION OF CALCIUM PYROPHOSPHATE CRYSTALS WITH ULTRASOUND: FINAL RESULTS OF THE OMERACT US IN CPPD SUB-TASK FORCE STUDY

Background:

The OMERACT Ultrasound (US) in calcium pyrophosphate deposition disease (CPPD) sub-task force has been working on the use of US in CPPD since 2014 first creating definitions for CPPD identification and then assessing the reliability[1].

Objectives:

Objective of this study is to assess the diagnostic accuracy (truth) of US in CPPD.

Methods:

Consecutive patients waiting to undergo knee replacement surgery due to osteoarthritis were enrolled in 12 centres from 6 countries. Each patient underwent US examination of the knee, focusing on the menisci and the hyaline cartilage, the day prior to surgery, scoring each site for presence/absence of CPP as defined previously[1]. After surgery, the menisci and the condyles were retrieved and examined microscopically. Six samples were collected, both from the surface and from the internal part of menisci and cartilage trying to cover a large part of it. All slides were observed under transmitted light microscopy and by compensated polarised microscopy. A dichotomous score was given for the presence/absence of CPP. US and microscopic analysis were performed by different operators, blind to each other’s findings. Sensitivity and specificity of US were calculated using microscopic findings as the gold standard.

Results:

101 patients have been enrolled in the study. 33 patients have been excluded due to loss of anatomical pieces at surgery. The mean age of the remaining 68 pts was 71yo (±8), 44 women, 34 were affected by CPPD according to microscopy. Overall and per site diagnostic US accuracy results are presented in table 1

Diagnostic accuracySensitivitySpecificityPositive Predictive valueNegative Predictive valueGlobal0.750.910.590.690.87Medial meniscus0.820.870.770.770.87Lateral meniscus0.750.830.680.680.83Medial cartilage0.860.790.920.880.85Lateral cartilage0.820.710.880.770.84Medial side (combined cartilage and meniscus)0.820.880.760.790.87Lateral side (combined cartilage and meniscus)0.780.880.690.730.86

Conclusion:

Our results demonstrate that US is an accurate exam for identification of CPPD. The best combination of sensitivity and specificity is achieved by examining the medial aspect of the knee.

References:

[1]Filippou G, Scirè CA, Adinolfi A,et al.Identification of calcium pyrophosphate deposition disease (CPPD) by ultrasound: reliability of the OMERACT definitions in an extended set of joints—an international multiobserver study by the OMERACT Calcium Pyrophosphate Deposition Disease Ultrasound Subtask Force.Ann Rheum Dis2018;:annrheumdis-2017-212542. doi:10.1136/annrheumdis-2017-212542

Disclosure of Interests:

Georgios Filippou: None declared, Anna Scanu: None declared, Antonella Adinolfi: None declared, Carmela Toscano: None declared, Dario Gambera: None declared, Raquel Largo: None declared, Esperanza Naredo: None declared, Emilio Calvo: None declared, Gabriel Herrero-Beaumont: None declared, Pascal Zufferey: None declared, Christel Madelaine-Bonjour: None declared, Daryl MacCarter: None declared, Stanley Makman: None declared, Zachary Weber: None declared, Fabiana Figus: None declared, Ingrid Möller: None declared, Marwin Gutierrez: None declared, Carlos Pineda: None declared, Denise Clavijo Cornejo: None declared, Héctor García: None declared, Victor Ilizaliturri: None declared, Jaime Mendoza Torres: None declared, Raul Pichardo: None declared, Luis Carlos Rodriguez Delgado: None declared, Emilio Filippucci Speakers bureau: Dr. Filippucci reports personal fees from AbbVie, personal fees from Bristol-Myers Squibb, personal fees from Celgene, personal fees from Roche, personal fees from Union Chimique Belge Pharma, personal fees from Pfizer, outside the submitted work., Edoardo Cipolletta: None declared, Teodora Serban: None declared, Catalin Cirstoiu: None declared, Florentin Ananu Vreju: None declared, Dun Grecu: None declared, Gael Mouterde: None declared, Marcello Govoni: None declared, Leonardo Punzi: None declared, Nemanja Damjanov Grant/research support from: from AbbVie, Pfizer, and Roche, Consultant of: AbbVie, Gedeon Richter, Merck, Novartis, Pfizer, and Roche, Speakers bureau: AbbVie, Gedeon Richter, Merck, Novartis, Pfizer, and Roche, Lene Terslev Speakers bureau: LT declares speakers fees from Roche, MSD, BMS, Pfizer, AbbVie, Novartis, and Janssen., Carlo Alberto Scirè: None declared, Annamaria Iagnocco Grant/research support from: Abbvie, MSD and Alfasigma, Consultant of: AbbVie, Abiogen, Alfasigma, Biogen, BMS, Celgene, Eli-Lilly, Janssen, MSD, Novartis, Sanofi and Sanofi Genzyme, Speakers bureau: AbbVie, Alfasigma, BMS, Eli-Lilly, Janssen, MSD, Novartis, Sanofi