title: Self management of arthritis in primary care: randomised controlled trial.
abstract: OBJECTIVE
  To evaluate clinical effectiveness of a self management programme for arthritis in patients in primary care with osteoarthritis.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  74 general practices in the United Kingdom.
  
  
  METHODS
  812 patients aged 50 and over with osteoarthritis of hips or knees (or both) and pain or disability (or both).
  
  
  METHODS
  Participants were randomised to six sessions of self management of arthritis and an education booklet (intervention group) or the education booklet alone (control group).
  
  
  METHODS
  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.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN79115352 [controlled-trials.com].
authors.affiliation: Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London N19 5LW. m.buszewicz@pcps.ucl.ac.uk
authors.forename: Marta
authors.initials: M
authors.lastname: Buszewicz
authors.forename: Greta
authors.initials: G
authors.lastname: Rait
authors.forename: Mark
authors.initials: M
authors.lastname: Griffin
authors.forename: Irwin
authors.initials: I
authors.lastname: Nazareth
authors.forename: Anita
authors.initials: A
authors.lastname: Patel
authors.forename: Angela
authors.initials: A
authors.lastname: Atkinson
authors.forename: Julie
authors.initials: J
authors.lastname: Barlow
authors.forename: Andy
authors.initials: A
authors.lastname: Haines
mesh_terms: D000368:Aged; D006233:Persons with Disabilities; D005194:Family Practice / Q000379:methods / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D011788:Quality of Life; D012648:Self Care / Q000379:methods / Q000592:standards*; D016896:Treatment Outcome