title: A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong.
abstract: The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of "shared care collaboration" between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong. katyccc@hotmail.com.|Department of Rheumatology & Immunology, Singapore General Hospital, Singapore, Singapore. katyccc@hotmail.com.
authors.forename: Ying-Ying
authors.initials: YY
authors.lastname: Leung
authors.affiliation: Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong.
authors.forename: Jackie
authors.initials: J
authors.lastname: Kwan
authors.affiliation: Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong.
authors.forename: Patsy
authors.initials: P
authors.lastname: Chan
authors.affiliation: Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong.
authors.forename: Peter K K
authors.initials: PK
authors.lastname: Poon
authors.affiliation: Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong.
authors.forename: Christine
authors.initials: C
authors.lastname: Leung
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
authors.forename: Lai-Shan
authors.initials: LS
authors.lastname: Tam
authors.affiliation: Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Sha Tin, Hong Kong.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Li
authors.affiliation: Community Rehabilitation Network, The Hong Kong Society for Rehabilitation, Kowloon, Hong Kong.
authors.forename: Anna
authors.initials: A
authors.lastname: Kwok
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000628:therapy*; D001172:Arthritis, Rheumatoid / Q000628:therapy*; D002908:Chronic Disease; D003153:Community Health Services / Q000458:organization & administration; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D010348:Patient Care Team; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011788:Quality of Life; D012017:Referral and Consultation; D012219:Rheumatology / Q000379:methods; D012648:Self Care / Q000379:methods*; D020377:Self Efficacy; D013167:Spondylitis, Ankylosing / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Chronic inflammatory arthritis; Lay leaders; Self-management; Shared-care model