105patients’ consecutive PROMs scores recorded with them. Electronic recording of
the data obtained facilitated expressing these fi gures as easy-to-read charts. Results
revealed that this new e-approach helped the patients to visualize the progress of
their disease activity course and response to therapy. Monitoring real-time changes
in disease activity provided patients with visual evidence of their responses to
treatment at different time points. Following 1-year of management, statistically
signifi cant differences were seen in disease activity parameters and patients’ will-
ingness to remain on treatment favoring the visual feedback approach. In addition,
the study depicted that viewing previous PROMs records (1) helped the patients
understand the effect of treatment on disease activity, (2) helped in medication
adherence, (3) improved trust in the treating physician, (4) alleviated concerns
about the future, and (5) helped in coping with daily life and disease. These fi nd-
ings highlight that keeping a record of the patient outcome measures and sharing
it with the patients not only is politically correct, in that the patients were involved
in the treatment, but the statistically signifi cant differences suggest that this
adjunctive therapy based on PROMs recordings may actually also have disease-
modifying potential.
Patient Education
Over the past years, there has been a signifi cant change in patient education
approaches. Traditionally, in standard clinical practice, patient education tended
to focus on helping patients to understand their disease and to give information
regarding the medication prescribed or interventions being used. This usually is
carried out using pre-prepared information leafl ets. On the other hand, in research
studies, patient education targeted behavior changes and enhancement of a
general sense of control as well as skill in coping with the disease and its sequelae
[ 25 – 27 ]. The newly adopted patient-centered care approach emphasized the
positive role of the patient in their treatment, or what is called “ self-manage-
ment .” The recently published guidelines from the National Institute for Health
and Clinical Excellence (NICE) [ 28 ] and EULAR [ 29 ] for infl ammatory arthritis
addressed the different aspects that need to be tackled by the appropriate patient
education programs. This includes major risk factors, such as cardiovascular,
falls, and osteoporosis/fracture risks, which may also account for increased mor-
tality, poor quality of life, and work disability, as well as comorbidities. Therefore,
patient educational programs should be tailored to the patient’s needs. Recent
studies [ 30 , 31 ] showed that PROMs can be used as a link between the disease
outcomes and patient education as it enables the treating physician and the patient
to identify the main points that need tackling. The integration of the PROMs and
patient education offered a new opportunity toward patient self-effi cacy in disease
management. A recently introduced patient education program, the “joint fi tness
program” adopted PROMs to identify the patient’s educational needs [ 32 ].
4 PROMs for Rheumatoid Arthritis