A pilot educational intervention to improve knowledge and readiness for self-management among patients with rheumatic...

Rheumatic diseases pose a significant challenge in Uganda, where access to care is limited. Patient self-management is an effective strategy for improving health outcomes. In collaboration with The Arthritis Association of Uganda (TAAU), a patient-led organization, we developed and piloted a virtual patient education series to support self-management. We hypothesized that it would be feasible and acceptable, and that we could collect measures regarding readiness for self-management and disease-related knowledge.

With input from TAAU, four sessions were developed: Introduction to Arthritis, Exercise & Nutrition, Women's Health & Rheumatic Disease, and Understanding My Disease & Rheumatology Medications. Adults receiving care at Mulago Hospital Rheumatology Clinic were invited to participate, and completed surveys assessing demographics, pre- and post-session self-management readiness via the Patient Activation Measure® (PAM®) and knowledge. Feasibility metrics were analyzed descriptively. Pre-post measures were evaluated using t-tests.

On average, 21 participants attended each session (48 ± 14 years, 64% women). Diagnoses included rheumatoid arthritis, osteoarthritis, lupus, and psoriatic arthritis. 33 enrollment and 41 Exit Surveys were collected. Most participants reported finding the sessions useful and the virtual format acceptable. Challenges included language barriers, internet connectivity, loss of hardcopy surveys, and weather-related delays. Mean PAM® levels increased from 2.2 to 2.9 (p < 0.001). Knowledge scores also improved across sessions (0.95 to 2.24 out of 4, p < 0.001).

This study demonstrates the feasibility and potential for virtual education to improve self-management and knowledge among patients with rheumatic diseases in Uganda. Future studies should address logistical challenges and assess long-term impacts. Key Points • A virtual patient education series focused on self-management, developed with patient input, was feasibility and acceptably implemented in a low-resource rheumatology clinic setting. • Measures regarding patient activation (readiness) for self-management and disease-related knowledge were successfully collected and preliminarily demonstrated improvement after the educational sessions. • Identified logistical challenges will help guide the future scale-up of self-management support interventions for patients with rheumatic disease in Uganda and similar low-resource settings.