Online Self-Management in Rheumatoid Arthritis: A Patient-Centered Model Application

Smarr, Karen L.; Musser, Dale; Shigaki, Cheryl L.; Johnson, Rebecca A.; Hanson, Kathleen Donovan; Siva, Chokkalingam

doi:10.1089/tmj.2010.0116

Cited by 25 publications

(45 citation statements)

References 51 publications

(46 reference statements)

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“…The final sample of studies were published in a variety of peer-reviewed journals, including the Journal of Medical Internet Research [47-51], CIN: Computers, Informatics, Nursing [52], Telemedicine and e-Health [53,54], Diabetes Care [55,56], The Diabetes Educator [57], Patient Education and Counseling [58], Arthritis & Rheumatism [59], Health Education and Behavior [60], and Journal of Pain and Symptom Management [61]. Included articles had been published between 2005 and 2012, with the majority (n=10 or 67%), published in 2010 or later.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies examined individuals with COPD [47,61], and two investigated patients with arthritis or related musculoskeletal disorders [54,59]. Three (n=3) other studies were designed for individuals suffering from one or more chronic condition(s) [52,53,60].…”

Section: Resultsmentioning

confidence: 99%

“…Eleven (n=11) studies were RCTs [47-50,52,55-58,60,61], while five adopted a randomized cluster [54], quasi-experimental [60], cross-sectional [51], or qualitative [53] design. Constructs from the social cognitive theory (eg, self-efficacy) were used in eight studies [47,50,54,56,57,59-61], while the social ecological theory and the 5 As (assess, advise, agree, assist, and arrange) self-management model were used in two studies [49,58].…”

Section: Resultsmentioning

confidence: 99%

“…Constructs from the social cognitive theory (eg, self-efficacy) were used in eight studies [47,50,54,56,57,59-61], while the social ecological theory and the 5 As (assess, advise, agree, assist, and arrange) self-management model were used in two studies [49,58]. Four reviewed studies did not specify a theoretical framework [48,52,53,55].…”

Section: Resultsmentioning

confidence: 99%

“…In five studies, use of Web 2.0 interventions was associated with statistically significant improvements in self-management self-efficacy [47,56,57,59,60], with one study noting positive trends falling just short of statistical significance ( P =.06) [56]. Four studies reported positive responses towards using Web 2.0 for communicating with health care providers (ie, nurses, care managers) [51-54], and five reviewed studies showed improvement in perceived social support [48,50,56,57,61]. …”

Section: Resultsmentioning

confidence: 99%

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Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

Stellefson¹,

Chaney²,

Barry³

et al. 2013

J Med Internet Res

275

251

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BackgroundParticipatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults.ObjectiveTo review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s).MethodsA systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles.ResultsMost interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication adherence, biological outcomes, or health care utilization. Mean SQS scores were notably low (mean=63%, SD 18%). Studies were judged to be weakest on the Maintenance dimension of RE-AIM; 13 reviewed studies (87%) did not describe any measures taken to sustain Web 2.0 effects past designated study time periods. Detailed process and impact evaluation frameworks were also missing in almost half (n=7) of the reviewed interventions.ConclusionsThere is need for a greater understanding of the costs and benefits associated with using patient-centered Web 2.0 technologies for chronic disease self-management. More research is needed to determine whether the long-term effectiveness of these programs is sustainable among larger, more diverse samples of chronically ill patients. The effective translation of new knowledge, social technologies, and engagement techniques will likely result in novel approaches for empowering, engaging, and educating older adults with chronic disease.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

Stellefson¹,

Chaney²,

Barry³

et al. 2013

J Med Internet Res

275

251

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RAHelp: An Online Intervention for Individuals With Rheumatoid Arthritis

Shigaki

Smarr²,

Siva

et al. 2013

Arthritis Care & Research

Self Cite

175

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Objective. To test an intervention for improving self-management in rheumatoid arthritis (RA) using an online, cognitive-behavioral, self-management group program (RAHelp), with weekly telephone support. Methods. A 2-group, randomized study design was used to compare an intervention for RA versus a waiting-list control condition. The intervention used a secure web site (RAHelp.org) to provide a 10-week program with weekly educational modules for improving self-efficacy in self-management of RA, plus tools for group interaction. Weekly telephone contacts were made to encourage use of program tools and apply newly learned skills. A nationwide convenience sample of 106 adult participants (mean age 50 years, 93% women) was recruited primarily through online advertisements. Main outcome measures included the Arthritis Impact Measurement Scales 2 (affective, physical, role, social, and pain/ symptom components), Arthritis Self-Efficacy Scale (ASES), Center for Epidemiologic Studies Depression Scale, Quality of Life Scale (QLS), Rapid Assessment of Disease Activity in Rheumatology, Social Provisions Scale, and University of California, Los Angeles Loneliness Scale 3. Results. Group differences with large and moderate effect sizes (ES

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Objective assessment of abnormal gait in patients with rheumatoid arthritis using a smartphone

et al. 2011

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A disturbance in gait pattern is a serious problem in patients with rheumatoid arthritis (RA). The aim of the present study was to examine the utility of the smartphone gait analysis application in patients with RA. The smartphone gait analysis application was used to assess 39 patients with RA (age 65.9 ± 10.0 years, disease duration 11.9 ± 9.4 years) and age-matched control individuals (mean age, 69.1 ± 5.8 years). For all RA patients, the following data were obtained: disease activity score (DAS) 28, modified health assessment questionnaire (mHAQ), and assessment of walking ability. Patients walked 20 m at their preferred speed, and trunk acceleration was measured using a Smartphone. After signal processing, we calculated the following gait parameters for each measurement terminal: peak frequency (PF), autocorrelation peak (AC), and coefficient of variance (CV) of the acceleration peak intervals. The gait parameters of RA and control groups were compared to examine the comparability of the 2 groups. Criterion-related validity was determined by evaluating the correlation between gait parameters and clinical parameters using Spearman's correlation coefficient. The RA group showed significantly lower scores for the walking speed, AC, and CV than the control group. There were no significant differences in PF. PF (gait cycle) was mildly associated with gait speed (P < 0.05). AC (gait balance) was moderately associated with the DAS, mHAQ, gait ability, and gait speed (P < 0.05). CV (gait variability) was moderately associated with the DAS, gait ability, and gait speed (P < 0.05). This is the first study to examine the use of a smartphone device for gait pattern measurement. The results suggest that some gait parameters recorded using the smartphone represent an acceptable assessment tool for gait in patients with RA.

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Online Self-Management in Rheumatoid Arthritis: A Patient-Centered Model Application

Cited by 25 publications

References 51 publications

Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

Web 2.0 Chronic Disease Self-Management for Older Adults: A Systematic Review

RAHelp: An Online Intervention for Individuals With Rheumatoid Arthritis

Objective assessment of abnormal gait in patients with rheumatoid arthritis using a smartphone

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