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Examining the impact of video-based outpatient education on patient demand for a rheumatology CNS service

14 October 2021
Volume 30 · Issue 18



Patient demand for education and access to the clinical nurse specialists (CNSs) during the rheumatology clinic at one hospital in Ireland was increasing. Alternative methods of providing patient education had to be examined.


To explore the efficacy of video-based outpatient education, and its impact on demand for the CNSs.


A video was produced to play in a rheumatology outpatient department. A representative sample of 240 patients (120 non-exposed and 120 exposed to the video) attending the clinic was selected to complete a questionnaire exploring the effect of the video. Data were analysed using chi-square tests with Yates' continuity correction.


Demand for the CNSs was six times higher in the non-exposed group compared with the exposed group (non-exposed: 25%, exposed: 4.8%) (χ2=15.7, P=0.00007), representing a significant decrease in resource demand.


High-quality educational videos on view in the rheumatology outpatient department provide patients with information sufficient to meet their educational needs, thus releasing CNS resources.

Patient education can be described as a set of planned, organised activities providing information to service users. Patient education aims to improve patient behaviours while optimising the health status of the individual to achieve positive long-term outcomes (Lovisi Neto et al, 2009). Patient education in chronic disease is particularly important as people must learn coping and adaptation mechanisms to deal with the progressive nature of certain conditions and the effects of long-term treatments (Ndosi and Adebajo, 2015; Senara et al, 2019).

Rheumatoid arthritis (RA) and the group of diseases known as the spondyloarthropathies (SpAs)—primarily psoriatic arthritis (PsA) and ankylosing spondylitis (AS)—are the most commonly found autoimmune conditions in the rheumatology clinic. Each are systemically driven diseases that can result in joint destruction, long-term disability, and premature mortality (Gabriel, 2008; Aletaha et al, 2010; Haroon et al, 2013; Hegarty et al, 2021). There are no curative treatments for these forms of arthritis and, as a result, some patients cycle through a number of treatment regimens. In addition, those who have refractory disease may develop joint destruction and disability at an early stage regardless of any treatments. This can be difficult for some patients to comprehend, especially at a time when they are at their most vulnerable during flares of their disease.

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