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Arthritis Care Res (Hoboken). 2015 Jul;67(7):913-22. doi: 10.1002/acr.22535.

Policy-into-practice for rheumatoid arthritis: randomized controlled trial and cohort study of e-learning targeting improved physiotherapy management.

Author information

1
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
2
School of Physiotherapy and Exercise Science, Curtin University and Department of Health, Government of Western Australia, Perth, Australia.
3
Tan Tock Seng Hospital, Singapore.
4
Curtin University and Department of Health, Government of Western Australia, Perth, and Arthritis and Osteoporosis Victoria, Elsternwick, Victoria, Australia.

Abstract

OBJECTIVE:

To examine the effectiveness of a physiotherapy-specific, web-based e-learning platform, "RAP-el," in best-practice management of rheumatoid arthritis (RA) using a single-blind, randomized controlled trial (RCT) and prospective cohort study.

METHODS:

Australian-registered physiotherapists were electronically randomized into intervention and control groups. The intervention group accessed RAP-eL over 4 weeks. Change in self-reported confidence in knowledge and skills was compared between groups at the end of the RCT using linear regression conditioned for baseline scores by a blinded assessor, using intent-to-treat analysis. Secondary outcomes included physiotherapists' satisfaction with RA management and responses to RA-relevant clinical statements and practice-relevant vignettes. Retention was evaluated in a cohort study 8 weeks after the RCT.

RESULTS:

Eighty physiotherapists were randomized into the intervention and 79 into the control groups. Fifty-six and 48, respectively, provided baseline data. Significant between-group differences were observed for change in confidence in knowledge (mean difference 8.51; 95% confidence interval [95% CI] 6.29, 10.73; effect size 1.62) and skills (mean difference 7.26; 95% CI 5.1, 9.4; effect size 1.54), with the intervention group performing better. Satisfaction in ability to manage RA, 4 of the 6 clinical statements, and responses to vignettes demonstrated significant improvement in the intervention group. Although 8-week scores showed declines in most outcomes, their clinical significance remains uncertain.

CONCLUSION:

RAP-eL can improve self-reported confidence, likely practice behaviors and satisfaction in physiotherapists' ability to manage people with RA, and improve their clinical knowledge in several areas of best-practice RA management in the short term.

PMID:
25630944
DOI:
10.1002/acr.22535
[Indexed for MEDLINE]
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