Impact of self-care programs for lower limb osteoarthritis and influence of patients' beliefs.
OBJECTIVE
To assess therapeutic education program impact for lower limb osteoarthritis (OA) at both the medical and surgical stage. Factors limiting efficiency and implementation of these programs such as patients' beliefs will be highlighted.


METHODS
A non systematic literature review on Medline and Cochrane Library databases from 1966 to 2009 using following key words "knee/hip osteoarthritis", "self-care/therapeutic education", "total hip/knee replacement/arthroplasty", "patients' beliefs" is conducted. Clinical trials and randomized clinical trials, as well as literature reviews and practice guidelines, published in English and French will be analysed.


RESULTS
Therapeutic education is part of the non-pharmacological management of chronic illnesses such as OA. The aim of education at an early stage of OA is to change patients' lifestyle, especially the regular practice of physical activity and weight reduction. Fears and avoidance assessment is necessary before patients' education process. When a surgical option is considered, the aim of education is to hasten patient recovery, improve autonomy after surgery, facilitate the return home and reduce the rate of transfer to a rehabilitation unit.


CONCLUSIONS
The efficacy of therapeutic education could be optimised for the management of OA with use of standardized rules and methods to deliver information and education. One way to improve therapeutic education in the management of OA could be to propose dedicated continuing medical education programs supported by specific economic sources for health care professionals.
Coudeyre
E
E
Clermont université, université d'Auvergne, 63000 Clermont-Ferrand, France. ecoudeyre@chu-clermontferrand.fr
Sanchez
K
K
Rannou
F
F
Poiraudeau
S
S
Lefevre-Colau
M-M
MM
D000368:Aged; D000369:Aged, 80 and over; D019468:Disease Management; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000628:therapy*; D010353:Patient Education as Topic; D015397:Program Evaluation; D012648:Self Care / Q000523:psychology*