Assessing patient, carer and healthcare professional education provided by the Birmingham Arthritis Resource Centre (BARC)

G. J. Treharne1,2, B. Batt3, E. D. Hale2, A. G. Witney1,2,3, C. Gordhan3,*, D. Situnayake4, E. Rankin5, G. D. Kitas1,2,3 and P. A. Bacon3

1 School of Psychology, University of Birmingham, 2 Department of Rheumatology, Dudley Group of Hospitals NHS Trust, Dudley, West Midlands, 3 Department of Rheumatology, Division of Immunity and Infection, School of Medicine, University of Birmingham, 4 Department of Rheumatology, South Birmingham Hospitals NHS Trust, City Hospital and 5 Department of Rheumatology, University Hospital Birmingham NHS Trust, Selly Oak, Birmingham, UK

Correspondence to: G. J. Treharne, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. E-mail: GJT884{at}bham.ac.uk.

SIR, We read with interest the editorial by Adebajo et al. [1] and agree on the importance of health education as a major factor in good quality healthcare. As they described, it is important to devise sound strategies to assess the impact of education about arthritis. We thank Adebajo et al. for their acknowledgement of the Birmingham Arthritis Resource Centre (BARC) and would like to take this opportunity to outline our project and research foci. BARC has been running for the past 3 yr and research to assess whether the centre is meeting its objectives has always been at the forefront of the project.

BARC was initially set up on the evidence base provided by a local corporate needs assessment [2]. The major objectives of BARC drawn from this consist of providing education about arthritis, signposting of other agencies and sources of information, as well as one-to-one support for all clients. As well as patients with arthritis or rheumatism, BARC provides support for informal carers of these patients (partners, family, etc.) and for healthcare professionals from all backgrounds. Providing support for underserved groups, especially people of non-Caucasian origin and/or people with literacy problems, is one of BARC's key aims. BARC's mission statement also includes helping all people with arthritis or rheumatism to maximize their quality of life. BARC's service is constantly expanding, with the recent opening of a bimonthly satellite subcentre in a primary-care setting to complement the main centre's community-based location in Birmingham's Central Library. Patient-friendly ‘bottom-up’ information, based on questions frequently asked, is also being compiled in the form of multilingual leaflets and an audio website.

A three-pronged research programme is addressing the effectiveness of BARC. Firstly, routine assessment of visitors to the centre or outreach talks is carried out by BARC's staff/volunteers using a standardized self-assessment questionnaire and some recent figures are presented below (full paper in preparation). Secondly, further in-depth investigation of the issues of importance to both the BARC volunteers (who generally have arthritis or rheumatism themselves) and clients is under way using semi-structured interviewing and qualitative analysis. Questions in these interviews include perceptions of medications, because these perceptions have been found to relate to adherence among people with rheumatoid arthritis [3] and because they inform us on the kind of information that is needed in medication information leaflets. Thirdly, a randomized controlled trial is being planned of referral to BARC of patients from secondary-care rheumatology services. The patient will know which arm they are in, but their rheumatologist will be blind to this (contrary to traditional single-blinding when the healthcare professional but not the patient knows which treatment is being received). With this we hope to demonstrate the efficacy of a visit to BARC for both new and established patients, who may benefit from education even after a disease duration of 10 yr [4]. We also hope to add to the existing evidence base that providing information leaflets alone improves patient knowledge [5].

Verbal informed consent was taken from all participants before they completed the questionnaire.

BARC's most recent figures (March 2003 to March 2004; 311 questionnaires) from the routine questionnaires indicate that having arthritis or rheumatism oneself was the most common reason for visiting BARC (60%), followed equally by informal carers (20%) and healthcare professionals (20%). More clients were women (61%) than men, but the age distribution of clients was encouragingly wide: around half of clients (53%) were aged above the average age (aged >56 yr). A significant proportion of clients were born outside the UK (19%). A slightly larger proportion was of an ethnic minority (26%). A noteworthy proportion of clients had some problem reading English (8%). Moreover, an important proportion of patients were not seeking any form of healthcare (12%). These figures demonstrate BARC's ability to reach underserved populations. Interestingly, more patients receiving healthcare were seeing a GP (75%) than receiving secondary care (41%), providing evidence for a particular need for referral from rheumatologists, as will be carried out in our trial. We will be providing further results on the effectiveness of BARC as they become available.

The authors have expressed no conflicts of interest.

Notes

*BARC manager. E-mail: barccentre{at}bham.ac.uk; website: http://webrheum.bham.ac.uk/barc Back

References

  1. Adebajo A, Blenkiron L, Dieppe P. Patient education for diverse populations. Rheumatology 2004; in press.
  2. Adab P, Rankin E, Witney AG et al. Use of a corporate needs assessment to define the information requirements of an arthritis resource centre in Birmingham: comparison of patients’ and professionals’ views. Rheumatology 2004; in press.
  3. Treharne GJ, Lyons AC, Kitas GD. Medication adherence in rheumatoid arthritis: effects of psychosocial factors. Psychol Health Med 2004;9:337–49.[CrossRef]
  4. Barlow JH, Cullen LA, Rowe IF. Comparison of knowledge and psychological well-being between patients with a short disease duration (≤1 year) and patients with more established rheumatoid arthritis (≥10 years duration). Patient Educ Counsel 1999;38:195–203.[CrossRef][ISI][Medline]
  5. Barlow JH, Wright CC. Knowledge in patients with rheumatoid arthritis: A longer term follow-up of a randomized controlled study of patient education leaflets. Br J Rheumatol 1998;37:373–6.[CrossRef][ISI][Medline]
Accepted 7 September 2004





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