The internet-based arthritis self-management program: a one-year randomized trial for patients with arthritis or fibromyalgia.
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 health-related 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.


CONCLUSIONS
The Internet-based ASMP proved effective in improving health status measures at 1 year and is a viable alternative to the small-group ASMP.
Lorig
Kate R
KR
Stanford University School of Medicine, Stanford, California, USA.
Ritter
Philip L
PL
Laurent
Diana D
DD
Plant
Kathryn
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D005260:Female; D005356:Fibromyalgia / Q000628:therapy*; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000628:therapy*; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D016896:Treatment Outcome