Self management of arthritis in primary care: randomised controlled trial.

Full Abstract

OBJECTIVE:
To evaluate clinical effectiveness of a self management programme for arthritis in patients in primary care with osteoarthritis.

DESIGN:
Randomised controlled trial.

SETTING:
74 general practices in the United Kingdom.

PARTICIPANTS:
812 patients aged 50 and over with osteoarthritis of hips or knees (or both) and pain or disability (or both).

INTERVENTION:
Participants were randomised to six sessions of self management of arthritis and an education booklet (intervention group) or the education booklet alone (control group).

MAIN OUTCOME MEASURES:
Primary outcome was quality of life, as assessed by the short form health survey (SF-36). Several other physical and psychosocial secondary outcomes were assessed. Data were collected at baseline, four months, and 12 months.

RESULTS:
Response rates were 80% and 76% at four and 12 months. The two groups showed significant differences at 12 months on the anxiety subscore of the hospital anxiety and depression scale (mean difference -0.62, 95% confidence interval -1.08 to -0.16), arthritis self efficacy scale for pain (0.98, 0.07 to 1.89), and self efficacy for other aspects of management (1.58, 0.25 to 2.90). Results were similar for intention to treat and per protocol analyses. No significant difference was seen in number of visits to the general practitioner at 12 months.

CONCLUSIONS:
The self management of arthritis programme reduced anxiety and improved participants' perceived self efficacy to manage symptoms, but it had no significant effect on pain, physical functioning, or contact with primary care.

TRIAL REGISTRATION:
Current Controlled Trials ISRCTN79115352 [controlled-trials.com].

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Author information

Author/s: Buszewicz, Marta (M); Rait, Greta (G); Griffin, Mark (M); Nazareth, Irwin (I); Patel, Anita (A); Atkinson, Angela (A); Barlow, Julie (J); Haines, Andy (A);

Affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London N19 5LW. m.buszewicz(-atsign-)pcps.ucl.ac.uk

Journal and publication information

Publication Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't

Journal: BMJ (Clinical research ed.) (BMJ), published in England. (Language: eng)

Reference: 2006-Oct; vol 333 (issue 7574) : pp 879

Dates: Created 2006/10/27; Completed 2006/11/08; Revised 2008/11/20;

PMID: 17040926, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: BMJ. 2006 Oct 28;333(7574):867-8. (PMID: 17068015)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Disabled Persons
Family Practice - methods; standards
Female
Humans
Male
Middle Aged

Middle Aged
Osteoarthritis, Hip - therapy
Osteoarthritis, Knee - therapy
Pain - etiology; prevention & control
Quality of Life
Self Care - methods; standards
Treatment Outcome

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