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Effectiveness of a novel digital patient education programme to support self-management of early rheumatoid arthritis: A randomised controlled trial

Knudsen, Line R; Ndosi, Mwidimi; Hauge, Ellen-Margrethe; Lomborg, Kirsten; Dreyer, Lene; Aaboe, Sidsel; Kjær, Marie B; Sørensen, Lis; Volsmann, Lena; Christensen, Heidi M; de Thurah, Annette


Line R Knudsen

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Dr Mwidimi Ndosi
Associate Professor in Nursing Rheumatology

Ellen-Margrethe Hauge

Kirsten Lomborg

Lene Dreyer

Sidsel Aaboe

Marie B Kjær

Lis Sørensen

Lena Volsmann

Heidi M Christensen

Annette de Thurah


Objectives To evaluate the effectiveness of a novel digital patient education (PE) programme in improving self-management in patients newly diagnosed with rheumatoid arthritis (RA). Methods This was a parallel, open-label, two arms, randomised controlled trial with superiority design. Patients from five rheumatology clinics were randomised into digital PE (intervention) or face-to-face PE (control). The primary outcome was self-efficacy, measured by average difference in the Rheumatoid Arthritis Self-Efficacy (RASE) score from baseline to month 12. Secondary outcomes were RA knowledge, health literacy, adherence, and quality of life. Healthcare utilisation data and digital PE programme usage were recorded. Self-efficacy, knowledge, and health literacy data were analysed using mixed-effects repeated measures modelling; adherence using logistic regression, and quality of life and healthcare utilization using descriptive statistics with the Wilcoxon rank-sum test. Results Of the 180 patients randomised (digital PE, n = 89; face-to-face PE, n = 91), 175 had data available for analysis. Median age was 59.0 years, and 61% were women. The average difference in self-efficacy between groups from baseline to month 12 was significant by a -4.34 difference in RASE score, favouring the intervention group (95%CI -8.17 to -0.51; p= 0.026). RA knowledge, health literacy, and quality of life showed minor improvements over time but no difference between groups, except out-patient clinic contacts which were fewer in the intervention group. Conclusions The findings suggest that digital PE is effective in improving self-efficacy and therefore self-management in patients with early RA. This intervention has potential to lower healthcare costs by decreasing out-patient clinic contacts. Trial registration number, NCT04669340


Knudsen, L. R., Ndosi, M., Hauge, E., Lomborg, K., Dreyer, L., Aaboe, S., …de Thurah, A. (in press). Effectiveness of a novel digital patient education programme to support self-management of early rheumatoid arthritis: A randomised controlled trial. Rheumatology,

Journal Article Type Article
Acceptance Date Mar 7, 2024
Online Publication Date Mar 18, 2024
Deposit Date Mar 27, 2024
Publicly Available Date Mar 19, 2025
Journal Rheumatology
Print ISSN 1462-0324
Electronic ISSN 1462-0332
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Keywords Pharmacology (medical), Rheumatology
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