Medical care of ankylosing spondylarthritis combines medications, rehabilitation, and patient's education.

Prospective evaluation of the impact of a patient's education program dedicated to patients affected by ankylosing spondylarthritis.

One hundred and eighty-six patients were involved in this program between 2007 and 2014. They underwent a mean of 25 sessions of multidisciplinary education. A complete team including physiotherapists, occupational therapists, nurses, dietetitians, chiropodists, psychiatrists, physical medicine and rehabilitation doctors, and rheumatologists conducted this program. It included teaching of auto-exercises by physiotherapists and occupational therapists, relaxation, balneotherapy, gymnastics, information on the disease and its care, including prevention of complications and management of treatment.

One hundred and forty-five patients (78%) completed the follow-up 6 months after the program. The average age of the patients is 42 years [17–78years], 51% were men. Seventy percent carried the gene HLA B27. The disease evolved for 13.6 years with a delay diagnostic of 8 years. 62% of the patients had a professional activity, 19% were in incapacity. Sixty-two percent were taking non steroidal anti-inflammatory drugs, 45% were under anti TNF treatment. Among the patients under anti TNF, 84% made lonely their own injections. 44% underwent regular physiotherapy, 15% practised self-rehabilitation. At the end of the program and at 6 months, 100% of the patients reported that the program met their needs and expectations. At 6 months, an improvement of the following parameters were observed: BASDAI 0.93 [5.4; 4.1] with P<0.001, BASFI 0.72 [7.41; 4] with P<0.011, EVA disease-1.01 [7; 4] with P=0.011, EVA pain-0.84 [8.4; 4] with P=0.012, stiffness 14.17 [180; 120] with P<0.001, count of pain joints 0.8 [31; 4] with P=0.011. An improvement was also noted concerning cervical mobilities and knowledge of the disease.

Our original program includes a physical and educational care of ankylosing spondylarthritis patients. It reaches initial goals to improve the quality of life of the patients.