J Rheum Dis 2018; 25(4): 255-262  
Effects of Individual Education Using a Treating-to-target Strategy in Patients with Rheumatoid Arthritis
Seung In Paek1, Seung Min Jung2, Jennifer Lee3, Seung-Ki Kwok3, Wan-Uk Kim3, Sung-Hwan Park3, Ji Hyeon Ju3, Kyeong-Yae Sohng4
1Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, 2Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, 3Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 4Department of Nursing, College of Nursing, The Catholic University of Korea, Seoul, Korea
Correspondence to: Kyeong-Yae Sohng http://orcid.org/0000-0002-4391-4481
Department of Nursing, College of Nursing, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. E-mail:sky@catholic.ac.kr
Ji Hyeon Ju http://orcid.org/0000-0001-7541-9103
Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul 06591, Korea. E-mail : juji@catholic.ac.kr
Received: May 17, 2018; Revised: July 26, 2018; Accepted: July 26, 2018; Published online: October 1, 2018.
© Korean College of Rheumatology. All rights reserved.

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Abstract
Objective. To examine effects of an individual education program using the treating rheumatoid arthritis to target (RA T2T) strategy in patients with moderate-severe rheumatoid arthritis. Methods. Patients were assigned randomly to an educational intervention (n=33) or conventional care group (n=33). The intervention was a nurse-delivered 9-month educational program consisting of 3 monthly sessions and monthly telephone counseling. The assessments occurred at the baseline and every 3 months in both groups, but only the intervention group completed the 9-month education follow-up. The outcome variables included the disease activity (DAS28), functional disability (KHAQ), fatigue (FACIT-Fatigue), and quality of life (SF-36). Repeated measures ANOVA and a Bonferroni multiple comparison were used to evaluate the outcome variables comparing the groups and follow-up times. Results. Significant interactions were observed between the groups and follow-up times in the disease activity (p=0.041), fatigue (p=0.042), and physical (p=0.006) and mental (p=0.031) health-related quality of life, but there was no significant interaction in the functional disability (p=0.110). Significant differences were noted between the groups at the 9-month period (p=0.048) in disease activity and fatigue, and at the 6-month (p=0.023) and 9-month periods (p=0.027) in the physical health-related quality of life. Conclusion. This education program using the RA T2T strategy had significant benefits on the disease activity, fatigue, and quality of life in patients with moderate to severe rheumatoid arthritis, and the results suggested that this contributed to positive clinical outcomes as a good practical nursing intervention.
Keywords: Rheumatoid arthritis, Patient education, Quality of life


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