The effects of patient education on patient cognition and dis-related anxiety

A rheumatoid arthritis patient education program was developed with objectives of increasing patient knowledge base and improving health status. Forty-six rheumatoid arthritis outpatients entered a three-session multidisciplinary education program. Each client was given a cognitive test and the Arthritis Impact Measurement Scale (AIMS) before, immediately after, and at remote follow-up. Data were analyzed to determine the effect of age and disease duration on clients' ability to benefit from group education. The effect of the program on physical and psychosocial parameters was also assessed. There was a significant increase in average cognitive scores between pre- and post-tests which remained at one month follow-up testing. Pre-test cognitive scores correlated positively with disease duration. At immediate post-test a correlation between anxiety scores and physical parameters was seen, which was not present on pre- or follow-up testing. No correlation was found between increase in cognitive scores and overall health status. Multivariate analysis of the AIMS test showed significant improvement in total health score at remote testing. Depression scores significantly improved from post to remote follow-up testing. This study suggests that one 'side effect' of patient education may be a transient worsening of psychological status in patients with greatest disease involvement.