Evaluation of a disease specific rheumatoid arthritis self-management education program, a single group repeated measures study.
BACKGROUND
Rheumatoid Arthritis is a progressive and disabling disease, predicted to increase in prevalence over the next 50 years. Self-management is acknowledged as an integral part in the management of chronic disease. The rheumatoid arthritis specific self-management program delivered by health professionals was developed by Arthritis Western Australia in 2006. The purpose of this study was to determine whether this program would achieve early benefits in health related outcomes, and whether these improvements would be maintained for 12 months.


METHODS
Individuals with rheumatoid arthritis were referred from rheumatologists. Participants with co-existing inflammatory musculoskeletal conditions were excluded. All participants completed a 6-week program. Assessments occurred at baseline (8 weeks prior to intervention), pre-intervention, post-intervention, and 6 and 12 month follow ups. Outcomes measured included pain and fatigue (numerical rating scale, 0-10), depression and anxiety (hospital anxiety and depression questionnaire), health distress, and quality of life (SF-36 version 2).


RESULTS
There were significant improvements in mean [SD] fatigue (5.7 [2.4] to 5.1 [2.6]), depression (6.3 [4.3] to 5.6 [3.9]) and SF-36 mental health (44.5 [11.1] to 46.5 [9.5]) immediately following intervention, with long term benefits for depression (6.3 [4.3] to 4.9 [3.9]), and SF-36 subscales mental health (44.5 [11.1] to 47.8 [10.9]), role emotional (41.5 [13.2] to 46.5 [11.8]), role physical (35.0 [11.0] to 40.2 [12.1]) and physical function (34.8 [11.5] to 38.6 [10.7]).


CONCLUSIONS
Participants in the program recorded significant improvements in depression and mental health post-intervention, which were maintained to 12 months follow up.
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
Vironique
V
Vermaak
School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia.
N Kathy
NK
Briffa
Department of Rheumatology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.
Bob
B
Langlands
Department of Rheumatology, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.|School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia.
Charles
C
Inderjeeth
Arthritis and Osteoporosis Western Australia, Perth, Western Australia, Australia. jeanm@arthritiswa.org.au.|Health, Education & Research Program Manager, Arthritis and Osteoporosis Western Australia, PO Box 34, Wembley WA 6913, 17 Lemnos St, Shenton Park, Western Australia, 6008, Australia. jeanm@arthritiswa.org.au.
Jean
J
McQuade
D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000523:psychology / Q000628:therapy*; D003131:Combined Modality Therapy; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology; D005239:Fear; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology / Q000209:etiology; D010147:Pain Measurement; D010353:Patient Education as Topic / Q000379:methods*; D010358:Patient Participation; D015397:Program Evaluation; D011788:Quality of Life; D012648:Self Care; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D016896:Treatment Outcome