A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong

Abstract

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

The effects of WeChat-based educational intervention in patients with ankylosing spondylitis: a randomized controlled trial

“…Some studies revealed that educational programs are effective for AS patients to improve health-related QoL [8,11,13], but others found reverse results [9,10,12]. Our study found that all domain scores of quality of life, except for physical function and vitality, were significantly higher in the intervention group compared with the control group after 12-week intervention, which means the education via WeChat can effectively improve QoL.…”

“…Patient education, as an effective, non-pharmacological treatment strategy for patients with AS, enables patients to manage their own conditions, enhances their ability to cope with disease, improves perceived health status, and maintains QoL [7]. Several previous studies explored the effects of educational interventions in patients with AS [8][9][10][11][12][13], but the effects of patient education on depression and quality of life are still unclear. Some studies used disease-specific measure to assess quality of life [8,12], which cannot compare QoL among individuals with different health conditions [4].…”

Self-efficacy and arthritis disability: An updated synthesis of the evidence base and its relevance to optimal patient care

“…Strong support for self-efficacy as a salient outcome predictor was forthcoming after that, given that program participation not only heightened self-efficacy test scores but also reduced medical services usage and related health-care costs (Lorig et al, 1993), a finding later supported by several independent researchers (e.g. Barlow and Barefoot, 1996; Barlow et al, 1999; Braden et al, 1993; Cross et al, 2006, Davis et al, 1994; Leung et al, 2014; Nuñez et al, 2009; Taal et al, 1993b; Yip et al, 2008). …”

Effects of WeChat-based Educational Intervention on Depression and Quality of Life in Patients with Ankylosing Spondylitis: A Randomized Controlled Trail

“…Some studies revealed that educational programs are effective to improve health related QoL [8,11,13], but others found reverse results [9,10,12]. The previous programs with small sample size, delivered by peer patients, reported no signi cant impact on improving QoL [10].…”

“…Patient education, as an effective, non-pharmacological treatment strategy for patients with AS, enables patients to manage their own condition, enhance their ability to cope with disease, improve perceived health status and maintain quality of life [7]. Several previous studies explored the effects of educational interventions in patients with AS [8][9][10][11][12][13], but the effects of patient education on depression and quality of life is still unclear. Some studies used disease speci c measure to assess quality of life [8,12], which can not compare the effects of education on QoL among individuals with different health conditions [4].…”