The internet‐based arthritis self‐management program: A one‐year randomized trial for patients with arthritis or fibromyalgia

Abstract

Objective. To determine the efficacy of an Internet-based Arthritis Self-Management Program (ASMP) as a resource for arthritis patients unable or unwilling to attend small-group ASMPs, which have proven effective in changing healthrelated behaviors and improving health status measures. Methods. Randomized intervention participants were compared with usual care controls at 6 months and 1 year using repeated-measures analyses of variance. Patients with rheumatoid arthritis, osteoarthritis, or fibromyalgia and Internet and e-mail access (n ‫؍‬ 855) were randomized to an intervention (n ‫؍‬ 433) or usual care control (n ‫؍‬ 422) group. Measures included 6 health status variables (pain, fatigue, activity limitation, health distress, disability, and self-reported global health), 4 health behaviors (aerobic exercise, stretching and strengthening exercise, practice of stress management, and communication with physicians), 5 utilization variables (physician visits, emergency room visits, chiropractic visits, physical therapist visits, and nights in hospital), and self-efficacy. Results. At 1 year, the intervention group significantly improved in 4 of 6 health status measures and self-efficacy. No significant differences in health behaviors or health care utilization were found. Conclusion. The Internet-based ASMP proved effective in improving health status measures at 1 year and is a viable alternative to the small-group ASMP.

Self‐efficacy and pain catastrophizing in systemic lupus erythematosus: Relationship to pain, stiffness, fatigue, and psychological distress

“…Disease activity is often associated with pain and symptom variables in samples of rheumatoid arthritis or osteoarthritis patients (16,35). Our results support the importance of assessing coping constructs in SLE patients, such as self-efficacy for pain control and pain catastrophizing, which are two pain coping cognition variables shown to be modifiable through the application of psychological interventions in other samples of patients with chronic pain conditions (17)(18)(19). Shifting treatment from a traditional medication approach (e.g., immunosuppressive therapy) to a multidisciplinary approach that includes addressing coping cognitions, such as selfefficacy and pain catastrophizing, as well as other psychosocial constructs, may have important clinical and economic importance.…”

“…Increased pain, physical, and psychological symptoms may lead to maladaptive patterns of coping, including higher pain catastrophizing and lower self-efficacy for pain control. On the other hand, prior interventional studies in other disease populations have documented that attention to these pain coping cognitions can lead to significant changes in the pain, physical, and psychological symptoms that a patient experiences (17)(18)(19). Given the limited success in improving these symptoms through traditional immunosuppressive therapy for SLE and the lack of a relationship between disease activity and pain, attention to pain coping cognitions could be a welcome and valuable addition to the treatment of patients with SLE.…”

“…These 2 pain coping cognition variables have been shown to be related to pain, stiffness, fatigue, and psychological disability in other samples of patients with persistent pain conditions (14 -16). It has been shown that, even in patients with high levels of pain, behavioral interventions can enhance a patient's self-efficacy in pain control, and that this can lead to lower levels of pain (17,18). Furthermore, there is evidence that behavioral interventions that systematically teach patients with persistent pain how to decrease catastrophic thinking about pain can produce significant decreases in pain (19).…”

Preoperative Pain Catastrophizing Predicts Pain Outcome after Knee Arthroplasty

“…The eight-item instrument is scored from 1 to 10 with higher scores indicating higher self-efficacy. Interventions designed to improve self-efficacy, the belief that one is capable of overcoming a disorder, are effective for patients with knee arthritis [36][37][38]. However, in one study of patients with hip or knee arthroplasty, preoperative self-efficacy apparently did not predict 6-month functional status, but only 23 of the 103 patients had knee arthroplasty [54].…”

An Evaluation of the Effectiveness of the Modalities Used to Deliver Electronic Health Interventions for Chronic Pain: Systematic Review With Network Meta-Analysis (Preprint)

“…Typically, an eHealth modality is considered to be some specific form of technology that is applied in the context of healthcare [2,3,4]. Examples of eHealth modalities include, internet-based [5,6,7,8,9], telephone supported [10], interactive voice response [11,12], virtual reality [13,14], video teleconferencing [15] and mobile phone applications [16,17].…”