Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians

• Published in: Journal of rheumatology 2007-05, Vol.34 (5), p.1112-1117
• Main Authors: OSBORNE, Richard H, WILSON, Tanya, LORIG, Kate R, MCCOLL, Geoffrey J
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Arthritis - physiopathology; Arthritis - psychology; Arthritis - rehabilitation; Australia; Biological and medical sciences; Disease Management; Diseases of the osteoarticular system; Fatigue - physiopathology; Fatigue - prevention & control; Female; Follow-Up Studies; Health Behavior; Health Status; Humans; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Outcome Assessment (Health Care); Pain - physiopathology; Pain - prevention & control; Patient Education as Topic; Quality of Life; Self Care - methods
• ISSN: 0315-162X; 1499-2752

OBJECTIVE: To evaluate the Arthritis Self-Management Course (ASMC) when applied in a nationwide context. METHODS: Four hundred fifty-two people who participated in the ASMC across Australian states took part in a longitudinal followup study. ASMC is a 6 week, 2 h group educational program designed to assist people with chronic illness to better manage their condition. Measures of program effectiveness included health status and service utilization. Data were collected on 3 occasions: before intervention (baseline) and 6 months and 2 years after the program. RESULTS: Several indicators of health status showed improvement at 6 months following the ASMC. These included reduction in pain (4%; p < 0.001), fatigue (3%; p < 0.01), and health distress (12%; p < 0.001) as well as increase in self-efficacy (6%; p < 0.001). Increased self-efficacy was a significant predictor of positive change in health status. Health-related behaviors such as aerobic exercise also increased, with the proportion of people who did little or no exercise decreasing by up to 8%. These changes were sustained at 2 years. There was an increase in use of analgesics at 6 months and an increase in use of nonsteroidal antiinflammatory drugs at 2 years. No changes in healthcare utilization (physician visits, allied health visits, and hospitalizations) were observed. CONCLUSION: The ASMC is a widely applied program in which participants benefit through a reduction in pain, fatigue, and health distress. Although the absolute changes in health status are small, the low cost and wide application of the intervention suggests the program may have a substantial public health effect.