Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries

Sarah E. Bennett; Heidi A. Zangi; Ingrid Larsson; Catherine Beauvais; Carina Boström; Andrea Domján; Yvonne Van Eijk-Hustings; Kristien Van Der Elst; Françoise Fayet; Ricardo J.O. Ferreira; Mie Fusama; Mariela Geneva-Popova; María Del Carmen Herrero Manso; Kirsten Hoeper; Bethan Jones; Marja Leena Kukkurainen; Suet Kei Gladys Kwok; Patricia Minnock; Tiziana Nava; Jette Primdahl; Roopa Rawat; Matylda Sierakowska; Michaela Stoffer-Marx; Astrid Van Tubergen; Mwidimi Ndosi

doi:10.1136/annrheumdis-2022-222253

Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries

Sarah E. Bennett, Heidi A. Zangi, Ingrid Larsson, Catherine Beauvais, Carina Boström, Andrea Domján, Yvonne Van Eijk-Hustings, Kristien Van Der Elst, Françoise Fayet, Ricardo J.O. Ferreira, Mie Fusama, Mariela Geneva-Popova, María Del Carmen Herrero Manso, Kirsten Hoeper, Bethan Jones, Marja Leena Kukkurainen, Suet Kei Gladys Kwok, Patricia Minnock, Tiziana Nava, Jette PrimdahlRoopa Rawat, Matylda Sierakowska, Michaela Stoffer-Marx, Astrid Van Tubergen, Mwidimi Ndosi

Department of Psychology

Research output: Contribution to journal › Article › peer-review

11 Citations (SciVal)

Abstract

Objectives To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. Methods A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. Results A total of 1159 completed the survey; 852 (73.5%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery. Conclusions This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools.

Original language	English
Pages (from-to)	1348-1357
Number of pages	10
Journal	Annals of the Rheumatic Diseases
Volume	81
Issue number	10
Early online date	8 Jun 2022
DOIs	https://doi.org/10.1136/annrheumdis-2022-222253
Publication status	Published - 8 Jun 2022

Bibliographical note

Publisher Copyright:
©

Data Availability Statement

No data are available. This was mixed methods
study involving analysis of qualitative and quantitative data therefore the data
generated are not suitable for sharing beyond that contained within the report.
Further information can be obtained from the corresponding author

Acknowledgements

This was a collaborative project and we wish to thank the
following people for their contribution in translating, pretesting and/or disseminating
the survey: Juliana Rachel Hoeper, Germany; Romualdo Ramos, Austria; Hana
Šmucrová, Czech Republic; Bodil Moberg, Sweden; Bente Appel Esbensen, Denmark;
Annette de Thurah, Denmark; Giulia Besana, Italy; Francesca Gualtieri, Italy; Silvia
García Díaz, Spain; Jenny de la Torre Aboki, Spain; Andréa Marques, Portugal;
Lurdes Barbosa, Portugal; Hideko Nakahara, Japan; Milena Pavić Nikolić, Slovenia;
Nikolino Žura, Croatia; Taina Pemberton, Heli Kuuluvainen, Eeva Tuomenoksa, Anita
Antinniemi, Finland; Marieke Scholte Voshaar, the Netherlands; Laure Gossec, Sonia
Tropé, Sandrine Rollot, Delphine Lafarge, Franck Gérald, Françoise Alliot-Launois,
Nathalie Robert, and Bénédicte Charles, France; An De Groef, Belgium; Lai Man
Tang, Hong Kong. We also want to thank the following organisations for their help
in disseminating the survey: The Finnish Association of Occupational Therapists,
Finnish Association of Physiotherapists, The Finnish Society for Rheumatology, The
Finnish Society of Rheumatology Nurses, Finland; Société Française de Rhumatologie,
France; and the Royal College of Nursing Rheumatology Forum, UK. We thank all
participants for taking time to complete the survey.

Funding

This work was funded by the European Alliance of Associations for Rheumatology (EULAR, Ref. HPR040).

Keywords

Arthritis
Health services research
Patient Care Team
Qualitative research

ASJC Scopus subject areas

Rheumatology
Immunology and Allergy
Immunology
General Biochemistry,Genetics and Molecular Biology

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Bennett, S. E., Zangi, H. A., Larsson, I., Beauvais, C., Boström, C., Domján, A., Van Eijk-Hustings, Y., Van Der Elst, K., Fayet, F., Ferreira, R. J. O., Fusama, M., Geneva-Popova, M., Herrero Manso, M. D. C., Hoeper, K., Jones, B., Kukkurainen, M. L., Gladys Kwok, S. K., Minnock, P., Nava, T., ... Ndosi, M. (2022). Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries. Annals of the Rheumatic Diseases, 81(10), 1348-1357. https://doi.org/10.1136/annrheumdis-2022-222253

Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries. / Bennett, Sarah E.; Zangi, Heidi A.; Larsson, Ingrid et al.
In: Annals of the Rheumatic Diseases, Vol. 81, No. 10, 08.06.2022, p. 1348-1357.

Research output: Contribution to journal › Article › peer-review

Bennett, SE, Zangi, HA, Larsson, I, Beauvais, C, Boström, C, Domján, A, Van Eijk-Hustings, Y, Van Der Elst, K, Fayet, F, Ferreira, RJO, Fusama, M, Geneva-Popova, M, Herrero Manso, MDC, Hoeper, K, Jones, B, Kukkurainen, ML, Gladys Kwok, SK, Minnock, P, Nava, T, Primdahl, J, Rawat, R, Sierakowska, M, Stoffer-Marx, M, Van Tubergen, A & Ndosi, M 2022, 'Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries', Annals of the Rheumatic Diseases, vol. 81, no. 10, pp. 1348-1357. https://doi.org/10.1136/annrheumdis-2022-222253

Bennett SE, Zangi HA, Larsson I, Beauvais C, Boström C, Domján A et al. Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries. Annals of the Rheumatic Diseases. 2022 Jun 8;81(10):1348-1357. Epub 2022 Jun 8. doi: 10.1136/annrheumdis-2022-222253

Bennett, Sarah E. ; Zangi, Heidi A. ; Larsson, Ingrid et al. / Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis : a mixed-methods study with rheumatology professionals in 23 European and Asian countries. In: Annals of the Rheumatic Diseases. 2022 ; Vol. 81, No. 10. pp. 1348-1357.

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abstract = "Objectives To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. Methods A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. Results A total of 1159 completed the survey; 852 (73.5\%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery. Conclusions This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools.",

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AU - Bennett, Sarah E.

AU - Zangi, Heidi A.

AU - Larsson, Ingrid

AU - Beauvais, Catherine

AU - Boström, Carina

AU - Domján, Andrea

AU - Van Eijk-Hustings, Yvonne

AU - Van Der Elst, Kristien

AU - Fayet, Françoise

AU - Ferreira, Ricardo J.O.

AU - Fusama, Mie

AU - Geneva-Popova, Mariela

AU - Herrero Manso, María Del Carmen

AU - Hoeper, Kirsten

AU - Jones, Bethan

AU - Kukkurainen, Marja Leena

AU - Gladys Kwok, Suet Kei

AU - Minnock, Patricia

AU - Nava, Tiziana

AU - Primdahl, Jette

AU - Rawat, Roopa

AU - Sierakowska, Matylda

AU - Stoffer-Marx, Michaela

AU - Van Tubergen, Astrid

AU - Ndosi, Mwidimi

PY - 2022/6/8

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N2 - Objectives To disseminate and assess the level of acceptability and applicability of the European Alliance of Associations for Rheumatology (EULAR) recommendations for patient education among professionals in rheumatology across Europe and three Asian countries and identify potential barriers and facilitators to their application. Methods A parallel convergent mixed-methods design with an inductive approach was used. A web-based survey, available in 20 different languages, was distributed to health professionals by non-probability sampling. The level of agreement and applicability of each recommendation was assessed by (0-10) rating scales. Barriers and facilitators to implementation were assessed using free-text responses. Quantitative data were analysed descriptively and qualitative data by content analysis and presented in 16 categories supported by quotes. Results A total of 1159 completed the survey; 852 (73.5%) were women. Most of the professionals were nurses (n=487), rheumatologists (n=320), physiotherapists (n=158). For all recommendations, the level of agreement was high but applicability was lower. The four most common barriers to application were lack of time, lack of training in how to provide patient education, not having enough staff to perform this task and lack of evaluation tools. The most common facilitators were tailoring patient education to individual patients, using group education, linking patient education with diagnosis and treatment and inviting patients to provide feedback on patient education delivery. Conclusions This project has disseminated the EULAR recommendations for patient education to health professionals across 23 countries. Potential barriers to their application were identified and some are amenable to change, namely training patient education providers and developing evaluation tools.

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Assessing acceptability and identifying barriers and facilitators to implementation of the EULAR recommendations for patient education in inflammatory arthritis: a mixed-methods study with rheumatology professionals in 23 European and Asian countries

Abstract

Bibliographical note

Data Availability Statement

Acknowledgements

Funding

Keywords

ASJC Scopus subject areas

Access to Document

Other files and links

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Cite this