Randomised, controlled trials of patient education with special reference to heart failure and joint diseases

University dissertation from Malmö University Hospital, 20502 Malmö

Abstract: In order to improve the treatment and care of patients with chronic diseases, controlled studies have to be performed continuously. It is widely believed that giving education/information to patients will increase their knowledge and compliance, which will decrease medical events and cost. Most educational activities in clinical practice are not based on evaluated models of effective disease management but rely on tradi- tional ways of education. Patient education has become an important part of management programmes, but very few studies employing modern computer- technology for patient education exist. · It is feasible to make educational programmes for patients with Kodak's Photo CD portfolio technique, a certified technology, at a low cost. The programmes are patient managed and interactive . The technique can be used by adult patients of any age as an integrated part of education of heart failure patients and patients with joint diseases. · The results of two educational studies (heart failure and joint diseases) showed that both intervention groups attained significantly higher knowledge than the controls. · Data from the evaluation of health care costs of heart failure patients was highly skewed and ranged from 4 605 to 124 997 SEK. The median cost for a single patient was 20 000 SEK for 6 months. · In patients' perceptions of diuretic drug treat- ment for heart failure, no relation between per- ception and prescribed dose was found. Further- more, the perceptions were almost not related to the age and sex of the patients. It is essential that new methods and materials intended for educational purposes are properly evaluated in clinical trials. Only after this procedure new methods and materials can be considered for use. Patients' perceptions about their drug treatment must be taken in considera- tion and further explored in clinical trials. The clinical impact of patients' increased knowledge, such as decreased rate of readmission, out-patient visits and drug related problems, must also be evaluated in clinical trials. The construction of interactive programmes can be developed for several medical conditions. Clinical trials using individual data from large patient populations are required to show reductions in health care costs.

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