FRI0735-HPR Knowledge, confidence and educational needs of primary care nurses' on patient education and continuity care in rheumatic diseases
Authors: R.J.O. Ferreira, A. Marques, I. Barbosa
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Primary care health professionals (HPs) are essential for continuity of care, especially for chronic conditions like rheumatic diseases. Therefore, knowledgeable and skilled HPs are needed in both settings, with close contact, to improve quality and safety. Primary care nurses may be pivotal to assure this continuity and liaison between care players. However, there is a lack of postgraduate rheumatology education for HPs working in this field<sup>1</sup>, a lack expected to be even greater in primary care. <h3>Objectives:</h3> We aimed to: 1) determine the knowledge on Disease Modifying Anti-Rheumatic Drugs (DMARDs) of nurses working in primary care in Portugal; 2) determine their confidence in providing patient education (PE) on (i) the rheumatic diseases they contact most, (ii) biological DMARDs and (iii) Methotrexate (MTX); 3) explore professional factors influencing these confidence levels; 4) explore their educational needs in rheumatology. <h3>Methods:</h3> A national online survey was performed among nurses working in primary settings for ≥6 months. The survey assessed their certifications, experience in primary care, and their practice, knowledge, and confidence (from 0 to 10) in providing PE to these patients. Their educational needs and communication with their colleagues in rheumatology were also assessed. Educational leaflets were provided at the survey9s end for didactic purpose. Spearman9s correlation and Mann-Whitney tests were used to test nurse9s confidence levels on PE. <h3>Results:</h3> There were 290 individuals accessing the survey, but only 129 (44.5%) completed it [mean age (SD)=42.6 (7.8) years, experience in primary care=13.7 (8.2) years; 47.3% having a post-graduate specialization]. Osteoarthritis (69.0%), low back pain (68.2), and rheumatoid arthritis (62.8%) were the diseases that nurses contact the most. Only 5.4% of nurses recognized an image with five sc bDMARDs pens, reporting frequent contact with them; 18.6% reported rare contact. Knowledge on bDMARDS was poor (table 1). More than half of nurses reported not knowing what PE to provide (55.0%) and when these drugs should be suspended for patient9s safety (63.6%); 55% never contacted with MTX and only 6.2% reported to know its side effects. Confidence levels in providing PE were low (figure 1) and not correlated (p&gt;0.05) with years of experience on primary care or with post-graduate specializations. Nurses9 doubts are answered mainly via internet (68.2%) or by local colleagues (51.2%). Only 2 nurses (1.6%) had formal, although minor, rheumatology education but 88.4% would like to have it (delivery preferences were expressed). <h3>Conclusions:</h3> Knowledge and confidence in key areas of rheumatology care seem to be very low in Portuguese nurses working in primary care. Unmet education and training needs exist and provide useful directions for the development of future training programmes. <h3>Reference</h3> 1. Vliet Vlieland TPM, et al. RMD Open2016;2:e000337. <h3>Disclosure of Interest:</h3> None declared