Self-Efficacy and the Role of Non-pharmacologic Treatment Strategies to Improve Pain and Affect in Arthritis

DiRenzo, Dana; Finan, Patrick H.

doi:10.1007/s40674-019-00123-z

Cited by 13 publications

(10 citation statements)

References 81 publications

(63 reference statements)

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“…Self-efficacy is therefore a major contributor to self-management behaviour and active coping, which in turn are promoters of psychological adjustment to chronic illness [ 10 ]. In other words, patients who are more self-efficacious can be more actively involved in the management of their disease, in a process of shared decision-making [ 11 ]. Shared decision-making involves patients working together with rheumatologists to provide the best possible care with regard to both scientific evidence and patient-specific goals and preferences [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis

et al. 2021

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Background Self-efficacy, or patients’ confidence in their ability to control disease and its consequences, was recently prioritised in EULAR recommendations for inflammatory arthritis self-management strategies. However, it remains unclear which factors influence self-efficacy in early rheumatoid arthritis (RA). Methods Data were analysed from the 2-year RCT Care in early RA (CareRA), which studied remission-induction treatment regimens for early RA. Participants completed the Arthritis Self-Efficacy Scale (ASES), Short-Form 36 (SF-36), Revised Illness Perception Questionnaire (IPQ-R), Utrecht Coping List (UCL), RAQoL and Health Assessment Questionnaire (HAQ). Depending on time to first remission (DAS28-CRP < 2.6) and persistence of remission, treatment response was defined as persistent response, secondary failure, delayed response, late response or non-response. The association between ASES scores and clinical/psychosocial factors was explored with Spearman correlation and multivariate linear mixed models. Baseline predictors of week 104 ASES were identified with exploratory linear regression followed by multiple regression of significant predictors adjusted for DAS28-CRP, HAQ, treatment arm, treatment response, cumulative CRP/SJC28 and demographic/serologic confounders. Results All 379 patients had a recent diagnosis of RA and were DMARD-naïve at study initiation. Most patients were women (69%) and RF/ACPA-positive (66%), and the mean (SD) age was 52 (13) years. For all tested outcome measures, better perceived health correlated with higher self-efficacy. While patient-reported factors (HAQ, SF-36, RAQoL, IPQ-R, pain, fatigue and patient’s global assessment) showed moderate/strong correlations with ASES scores, correlations with physician-reported factors (physician’s global assessment, SJC28), TJC28 and DAS28-CRP were weak. Only more favourable outcomes on patient-reported factors and DAS28-CRP were associated with higher ASES scores at each time point. An earlier, persistent treatment response predicted higher ASES scores at both weeks 52 and 104. Significant baseline predictors of week 104 ASES included HAQ; SF-36 mental component score, vitality, mental health and role emotional; IPQ-R illness coherence, treatment control, emotional representations and consequences; UCL Passive reacting; and the RAQoL. Conclusions Patient-reported outcomes and treatment response were early determinants of long-term self-efficacy in an early RA trial. These results provide further relevance for the window of opportunity in an early treat-to-target strategy and could help to timely identify patients who might benefit from self-management interventions. Trial registration EudraCT 2008-007225-39

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Section: Introductionmentioning

confidence: 99%

Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis

et al. 2021

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“…If orally taken medications are ineffectual, intraarticular injection (corticosteroids, viscosupplements, blood-derived products) is a nonoperative option. 4,5 Corticosteroids contain anti-inflammatory as well as immunosuppressive properties, but their mechanism of action is complicated. The adrenal cortex produces steroid hormones called corticosteroids, which include glucocorticoids and mineralocorticoids.…”

Section: Original Articlementioning

confidence: 99%

Efficacy of Intra Articular Steroid Injection and Platelet Rich Plasma in Patients with Osteoarthrithis

Khan

Khursheed

Sharif

et al. 2022

Ann Pak Inst Med Sci

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Objective: To compare the efficacy of intra-articular steroid injection and Platelet rich plasma in patients with Osteoarthrithis. Methodology: A randomized controlled trail study was conducted at Rheumatology Division of the Department of Medicine, Pakistan Institute of Medical Sciences, Islamabad after the acceptance of synopsis from . A total of 122 adult patients with unilateral or bilateral osteoarthritis of knee and were randomized into two treatment groups. In Group I, patients received intra-articular steroid injections and in Group II, patients received platelet rich plasma (PRP). WOMAC score was calculated at baseline and was subsequently assessed after 06 weeks and 3 months. Results: Age and gender distribution and mean WOMAC and VAS scores were similar in both groups at baseline (p>0.05). At six weeks, mean WOMAC score in steroid group was 32.1 ± 24.1 and it was 24.9 ± 21.3 in PRP group (P=0.084). Mean VAS in steroid group was 4.5 ± 2.5 and it was 3.9 ± 2.6 in PRP group (P=0.0.158). At three months, mean WOMAC score in steroid group was 39.1 ± 24.3 SD and it was 27.1 ± 21.9 SD in PRP group (P=0.005). At three months, mean VAS in steroid group was 5.6 ± 2.6 and it was 4.1 ± 2.7 in PRP group (P=0.003). Conclusions: The study outcomes were better in patients treated with PRP as compared to intra-articular steroid injection. Mean WMOAC and VAS scores were significantly lower after three months in PRP group as compared to steroid group.

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“…Furthermore, DHA can contribute to improved self-efficacy, which in turn is one of the most important psychological factors that reflects patients’ confidence in disease management and was found as a strong predictor of self-management behaviors [ 19 ]. Importantly, a high level of self-efficacy also corresponds with lower levels of fatigue, pain, physical and psychological disability in patients with arthritis [ 20 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of a mobile app intervention in patients with inflammatory arthritis: a prospective pilot study

et al. 2022

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EULAR highlighted the essential role of digital health in increasing self-management and improving clinical outcomes in patients with arthritis. The objective of this study was to evaluate the efficacy and safety of the digital health application (DHA) in patients with inflammatory arthritis. We assessed demographic parameters, treatment regimen, disease activity, and other patient-reported outcomes at baseline and after 4 weeks of DHA use added to standard care treatment. Of 17 patients, who completed the study, 7 (41.2%) patients were male, ranging from 19 to 63 (40.5 ± 12.2) years. No significant change in antirheumatic treatment was observed during the study. Statistically significant improvements (p < 0.05) were noted for health-related quality of life (increase in Physical Component Summary of Short Form-36 (SF-36) by 23.6%) and disease activity (decrease of Clinical Disease Activity Index and Simple Disease Activity Index by 38.4% and 39.9%, respectively). Clinically significant improvement was demonstrated for SF-36 Total Score (+ 14.4%), disease activity (Rheumatoid Arthritis Disease Activity Index− 5 to 15.9%), and depression (Patient Health Questionnaire− 9 to 13.5%). None of the efficacy parameters showed negative trends. No adverse events were reported throughout the study. The usability level was high i.e., the mean mHealth Application Usability Questionnaire Score of 5.96 (max.: 7.0) demonstrated a high level of application usability. This suggests that using a personalized disease management program based on DHA significantly improves several measures of patient-reported outcomes and disease activity in patients with inflammatory arthritis in a timely manner. These findings highlight the potential of complementary digital therapy in patients with inflammatory arthritis.

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Self-Efficacy and the Role of Non-pharmacologic Treatment Strategies to Improve Pain and Affect in Arthritis

Cited by 13 publications

References 81 publications

Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis

Treatment response and several patient-reported outcomes are early determinants of future self-efficacy in rheumatoid arthritis

Efficacy of Intra Articular Steroid Injection and Platelet Rich Plasma in Patients with Osteoarthrithis

Efficacy and safety of a mobile app intervention in patients with inflammatory arthritis: a prospective pilot study

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