393PROMs and Patient Education Programs
In standard clinical settings, two approaches to patient education and self-
management have been adopted: the fi rst is a condition/disease-specifi c self-
management program , covering topics such as: managing fl are-ups, pain, and
fatigue; better use of medication; understanding the benefi ts of pacing; and action
planning. The second approach is patient specifi c, adopting an individualized self-
management program tailored to the patient’s needs [ 5 , 20 – 32 , 37 ]. Recent reports
[ 32 , 37 ] revealed that patient-reported outcome measures can be used as a link
between disease outcomes and patient education, as they enable the treating physi-
cian and the patient to identify the priority areas that need tackling. The integration
of PROMs and patient education offered a new opportunity toward improving
patient self-effi cacy in disease management. Joint Fitness Program [ 38 ], a newly
structured patient-derived education program, was recently published as an initia-
tive for people suffering from infl ammatory arthritis and/or joint pains. It showed
how self-management can be tailored to match patients’ needs as identifi ed from the
PROMs questionnaire. This represents a step forward in the management of patients
suffering from chronic infl ammatory musculoskeletal conditions as it integrates the
education model into the routine clinical practice aiming at providing a care path-
way matching the patient’s needs. Thus the self-management/patient education pro-
gram can be amended and tailored more than once to meet the patient’s changing
condition throughout their disease trajectory. Using PROMs for assessing and mon-
itoring patient education also supports the patients in identifying their own health
needs and responding to them by setting their own specifi c goals (knowledge/
behavioral/psychosocial). Such an individualized need-based approach represents
best practice and may help encourage patient motivation.
PROMs and Clinical Outcomes of Patient Education
The potential effect of patient education on disease outcome is of prime concern to
both patients and treating clinicians. Quantitative evaluation of the impact of the
educational intervention on the clinical outcomes, such as disease activity parame-
ters as well as the patient ou tcomes including functional ability and quality of life,
play an important role in the patient’s day-to-day management. Furthermore, it
helps to estimate the extent to which the educational goals translate to meaningful
measures. Whilst there are specifi c tools to assess for the educational activity out-
comes [ 33 , 39 , 40 ], these remain dedicated for research activities and cannot be
implemented in standard clinical practice. A recent study [ 40 ] assessed the usability
of the Educational Needs Assessment Tool (ENAT) in clinical practice, from a prac-
titioner and patient perspective. Completing the ENAT, prior to clinical assessment,
helped the patients to focus on what they needed to know from their visit on that day.
However, this means the need for a dedicated session for educational needs assessment.
16 PROMs and Patient Education