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Policy‐Into‐Practice for Rheumatoid Arthritis: Randomized Controlled Trial and Cohort Study of E‐Learning Targeting Improved Physiotherapy Management
Author(s) -
Fary Robyn E.,
Slater Helen,
Chua Jason,
Ranelli Sonia,
Chan Madelynn,
Briggs Andrew M.
Publication year - 2015
Publication title -
arthritis care and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.032
H-Index - 163
eISSN - 2151-4658
pISSN - 2151-464X
DOI - 10.1002/acr.22535
Subject(s) - rheumatoid arthritis , randomized controlled trial , physical therapy , medicine , cohort
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.