[Effects of patient education in asthma and COPD--what is provable?]. Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. A comparison of lay-taught and professional-taught arthritis self-management courses. Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. A randomized controlled study of the Arthritis Self-Management Programme in the UK. Outcomes of self-help education for patients with arthritis. A reexamination of the effectiveness of self-care education for persons with arthritis. A randomised control trial of a self-management program for people with a chronic illness from Vietnamese, Chinese, Italian and Greek backgrounds. Self-management in osteoarthritis of hip or knee: a randomized clinical trial in a primary healthcare setting. Moderators of chronic disease self-management programs: who benefits? A Randomized Trial of a Lay Person‐Led Self‐Management Group Intervention for Back Pain Patients in Primary Care A randomized, controlled clinical trial of education and physical training for women with fibromyalgia. Hispanic Chronic Disease Self-Management: A Randomized Community-Based Outcome Trial Randomized controlled trial of a community-based psychoeducation program for the self-management of chronic pain Persistent functional and social benefit 5 years after a multidisciplinary arthritis training program. Community-based Spanish language arthritis education program: a randomized trial. Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease. Chronic disease self-management program for low back pain in the elderly. The effects of a health educational and exercise program for older adults with osteoarthritis for the hip or knee. Impact of self-management education on the functional health status of older adults with heart disease. Group education for patients with rheumatoid arthritis.
In international and national guidelines patient education is recommended as an integral part of an effective management for both , asthma and COPD , respectively . The evaluation of numerous structured education programs for adult asthmatics revealed an increase of quality of life of the educated patients , reduced morbidity with less asthmatic attacks , a decrease of emergency visits , sick leave days and hospitalizations due to asthma . On the basis of cost/benefit analysis cost effectiveness could be demonstrated for education programs for asthmatics . On the basis of education programs in COPD including self-management , in a r and omized controlled study an improvement of the patient 's ability to react to exacerbations could be shown , thus reducing the morbidity by the disease . Further controlled studies of the effects of patient education on morbidity , mortality and cost effectiveness are necessary to establish the role of structured education programs in the treatment of COPD with sufficient validity OBJECTIVE Studies have suggested that the Arthritis Self-Management Program ( ASMP ) course is effective at reducing arthritis pain and health care costs  in volunteer participants . There have been no reports of trials of the ASMP in the context of primary care physicians ' practice s , where the potential for spreading the program may be greatest . We conducted a r and omized controlled trial of the ASMP course in a large primary care physician network . METHODS Patients with osteoarthritis , rheumatoid arthritis , or fibromyalgia were recruited for the study . Subjects in the intervention practice s received the 6 week course and those in the control practice s received only the ASMP book , without course .  Disability , pain , self-efficacy , mental health , and satisfaction were measured using vali date d instruments at baseline and at 4 months . RESULTS One hundred thirteen patients were recruited for the ASMP course  ( intervention ) and completed baseline and 4 month followup question naires . Eighty-four percent completed at least 4 of 6 classes . Seventy-four patients received the ASMP manual ( controls ) and completed both question naires . Patients in the intervention and control groups had similar baseline pain ( p = 0.94 ) , self-efficacy to control pain ( p = 0.90 ) , mental health ( p = 0.10 ) , and vitality scores ( p = 0.21 ) , but those in the intervention arm had slightly less disability ( p = 0.04 ) . At 4 months , there was no significant improvement from baseline in any endpoint and no difference between patients in the intervention and control groups ( all p > 0.2 ) . Patient satisfaction with arthritis care and outcomes was no different for intervention and control patients ( all p > 0.3 ) . All types of health care re source use were similar at baseline and followup for both intervention and control groups ( all p > 0.2 ) . CONCLUSION While the ASMP course has been found to be effective in other patient groups , there were no significant clinical benefits noted at 4 months in patients recruited from primary care practice OBJECTIVES This study evaluated the effectiveness ( changes in health behaviors , health status , and health service utilization ) of a self-management program for chronic disease design ed for use with a heterogeneous group of chronic disease patients . It also explored the differential effectiveness of the intervention for subjects with specific diseases and comorbidities . METHODS The study was a six-month r and omized , controlled trial at community-based sites comparing treatment subjects with wait-list control subjects .  Participants were 952 patients 40 years of age or older with a physician-confirmed diagnosis of heart disease , lung disease , stroke , or arthritis .  Health behaviors , health status , and health service utilization , as determined by mailed , self-administered question naires , were measured . RESULTS Treatment subjects , when compared with control subjects , demonstrated improvements at 6 months in weekly minutes of exercise , frequency of cognitive symptom management , communication with physicians , self-reported health , health distress , fatigue , disability , and social/role activities limitations . They also had fewer hospitalizations and days in the hospital . No differences were found in pain/physical discomfort , shortness of breath , or psychological well-being . CONCLUSIONS An intervention design ed specifically to meet the needs of a heterogeneous group of chronic disease patients , including those with comorbid conditions , was feasible and beneficial beyond usual care in terms of improved health behaviors and health status . It also result ed in fewer hospitalizations and days of hospitalization One hundred subjects with arthritis were r and omized into lay-taught , or professional-taught 12-h arthritis self-management courses , or a control group .  Outcomes , knowledge , exercise , relaxation , disability , pain , and number of physician visits were measured aat baseline and 4 months . Professional-taught groups demonstrated greater knowledge gain while lay-taught groups had greater changes in relaxation ( p less than .01 ) and a tendency toward less disability . Although it is impossible to draw definitive conclusions , this study suggests that lay leaders can teach arthritis self-management courses with results similar to those achieved by professionals OBJECTIVE To evaluate the effectiveness of the Shanghai Chronic Disease Self-Management Program ( CDSMP ) . METHODS A r and omized controlled trial with six-month follow-up compared patients who received treatment with those who did not receive treatment ( waiting-list controls )  in five urban communities in Shanghai , China . Participants in the treatment group received education from a lay-led CDSMP course and one copy of a help book immediately ; those in the control group received the same education and book six months later . FINDINGS In total , 954 volunteer patients with a medical record that confirmed a diagnosis of hypertension , heart disease , chronic lung disease , arthritis , stroke , or diabetes who lived in communities were assigned r and omly to treatment ( n = 526 ) and control ( n = 428 ) groups . Overall , 430 ( 81.7 % ) and 349 ( 81.5 % ) patients in the treatment and control groups completed the six-month study . Patients who received treatment had significant improvements in weekly minutes of aerobic exercise , practice of cognitive symptom management , self-efficacy to manage own symptoms , and self-efficacy to manage own disease in general compared with controls . They also had significant improvements in eight indices of health status and , on average , fewer hospitalizations . CONCLUSION When implemented in Shanghai , the CDSMP was acceptable culturally to Chinese patients . The programme improved participants ' health behaviour , self-efficacy , and health status and reduced the number of hospitalizations six months after the course . The locally based delivery model was integrated into the routine of community government organizations and community health services . Chinese lay leaders taught the CDSMP courses as successfully as professionals The objective of this study was to determine whether the Arthritis Self-Management Programme ( ASMP ) improves perceptions of control , health behaviours and health status , and changes use of health care re sources . The design was a pragmatic r and omized controlled study ; participants were allocated to ASMP ( Intervention Group ) or a 4-month waiting-list Control Group . The Intervention Group completed a 12-month follow-up . In total , 544 people with arthritis were recruited from the community--311 in the Intervention Group and 233 in the Control Group . Main outcome measures included : arthritis self-efficacy , health behaviours ( exercise , cognitive symptom management , diet and relaxation ) and health status ( pain , fatigue , anxiety , depression and positive affect ) . At 4 months follow-up , the ASMP had a significant effect on arthritis self-efficacy for other symptoms and pain subscales . Performance of a range of health behaviours ( cognitive symptom management , communication with physicians , dietary habit , exercise and relaxation ) was significantly greater among the Intervention Group . The Intervention Group were significantly less depressed and had greater positive mood . In addition , trends towards decreases on fatigue and anxiety were noted . Physical functioning , pain and GP visits remained stable at 4 months . A similar pattern of findings was found at 12 months follow-up for the Intervention Group . Furthermore , a significant improvement was found on pain and visits to GPs had decreased . Apart from a small improvement on physical functioning among the Intervention Group participants with osteoarthritis 12 months , all effects were independent of the type of arthritis . The findings suggest that the ASMP is effective in promoting improvements in perception of control , health behaviours and health status , when delivered in UK setting Behavioral and health status outcomes of an unreinforced , self-help education program for arthritis patients taught by lay persons were examined in 2 ways : a 4-month r and omized experiment and a 20-month longitudinal study . At 4 months , experimental subjects significantly exceeded control subjects in knowledge , recommended behaviors , and in lessened pain . These changes remained significant at 20 months . The course was inexpensive and well-accepted by patients , physicians , and other health professionals We examined the effectiveness of 2 models of arthritis self-care intervention , the home study model and the small group model . The effects of disease diagnosis and duration , self-care behavior , perceived helplessness , social support , treatment choice , and formal education level on outcomes among persons with arthritis who participated in these programs were evaluated . A pretest-posttest control group design was utilized in the initial experimental study ; comparison group design s were used in the longitudinal studies . Three hundred seventy-four subjects completed the interventions and 12 months of research followup . We found that the intervention models had a statistically significant positive impact on arthritis knowledge , self-care behavior , perceived helplessness , and pain . These findings did not vary when the effects of education level , disease diagnosis and duration , informal social support , and treatment choice were controlled . The small group intervention was more effective in bringing about initial improvements in pain and depression , whereas the home study intervention was more effective in maintaining improvements in perceived helplessness . Changes in perceived helplessness and self-care behavior appear to explain in part the observed improvement in pain OBJECTIVE This study investigated the effectiveness of the Chronic Disease Self-management Program ( CDSMP ) when delivered to for people from Vietnamese , Chinese , Italian and Greek background s living in Victoria , Australia . METHOD The CDSMP was administered to 320 people with chronic illnesse(es ) in selected low income areas in the State of Victoria , Australia . At 6 months , they were compared with r and omised wait-list control subjects ( n=154 ) using analyses of covariance . RESULTS Participants in the intervention group had significantly better outcomes on energy , exercise , symptom management , self-efficacy , general health , pain , fatigue and health distress . There were no significant effects for health services utilisation . Interactions across language groups were observed with the Vietnamese and Chinese speaking participants gaining greater benefit . CONCLUSION Self-management programs can be successfully implemented with culturally and linguistically diverse population s in Australia . Further research is needed to evaluate long-term outcomes ; explore effects on service utilisation ; and to determine whether the benefits obtained from participating in a self-management program can be maintained . PRACTICE IMPLICATION S Self-management programs should be considered for people from culturally and linguistically diverse background s. Care also needs to be taken in design ing recruitment strategies to minimize withdrawal rates and to ensure harder to reach people are given encouragement to participate OBJECTIVE To assess in a primary healthcare setting the efficacy of a self-management program in middle-aged patients with osteoarthritis ( OA ) . METHODS This was a 2-group r and omized controlled trial , with 273 patients aged 40 to 60 years with OA of the hip(s ) and /or knee(s ) . The experimental intervention was compared with care-as-usual . Treatments and followup measurements were performed in a general healthcare setting by general practitioners . Duration of followup was 21 months after start of the intervention . Instruction in self-management techniques was given by physiotherapists . The main outcome measures were pain severity in hips and knees , other significant complaints , and functional limitations . RESULTS To begin , 297 patients were r and omized : 149 as self-management and 148 controls ; before the intervention 24 withdrew for practical reasons ( 17 self-management  , 7 controls ) . At 3-month followup the intervention group was significantly improved on a visual analog scale ( VAS ) for knee pain ( score 0.67 ; SD 2.10 ) and the WOMAC ( score 2.46 ; SD 9.49 ) , while the control group showed stable VAS knee pain ( 0.01 ; SD 2.00 ) and deterioration on WOMAC ( -0.53 ; SD 9.47 ) . At 21-month followup the differences between the groups increased in favor of the intervention group ( VAS pain knee : p values from 0.023 at 3 mo to 0.004 at 21 mo ; WOMAC : p values from 0.030 to 0.022 ) . CONCLUSION The self-management program positively influenced knee pain and self-reported functional level in this sample of patients with OA . Differences between the study groups increased during followup in favor of the intervention group Background : The Stanford University Chronic Disease Self-Management Program ( CDSMP ) has result ed in moderate beneficial outcomes in r and omized controlled trials . A study of a modified CDSMP in Engl and suggested that younger participants , those with lower initial self-efficacy and those with greater depression benefited most from the program . Design : Using data from previous CDSMP programs in English and Spanish , we examined whether there were statistically significant interactions between baseline statuses ( demographic , disease and health status variables ) and r and omization ( intervention or usual-care control ) in estimating 6-month changes in health status ( health distress , activity limitation/role function , self-efficacy and self-reported general health ) . If an interaction was found , post hoc examinations of the relationships between the baseline variables and outcomes determined the directions of the relationships . Results : Six moderating variables were found in the original English- language CDSMP and three in the Spanish program . Each moderator was specific to only one outcome within only one of the two studies . Conclusion : There were no consistent moderating effects across four outcomes and two programs and little evidence to suggest that any groups should be targeted for program recruitment . The CDSMP appears to remain useful to a wide range of people with chronic illness Study Design . R and omized , controlled trial . Objective . To evaluate a four‐session self‐management group intervention for patients with pain in primary care , led by trained lay persons with back pain . The intervention was design ed to reduce patient worries , encourage self‐care , and reduce activity limitations . Background Data . R and omized trials of educational interventions suggest that activating interventions may improve back pain outcomes . Expert opinion increasingly regards effective self‐management of back pain as important in achieving good outcomes . In this study , an educational intervention design ed to activate patients and support effective self‐management was evaluated . Methods . Six to 8 weeks after a primary care visit for back pain , patients were invited to participate in an educational program to improve back pain self‐management . Those showing interest by returning a brief question naire became eligible for the study . Participants ( n = −255 ) r and omly were assigned to either a self‐management group intervention or to a usual care control group . The effect of the intervention , relative to usual care , was assessed 3 , 6 , and 12 months after r and omization , controlling for baseline values . The intervention consisted of a four‐session group applying problem‐solving techniques to back pain self‐management , supplemented by educational material s ( book and videos ) supporting active management of back pain . The groups were led by lay persons trained to implement a fully structured group protocol . The control group received usual care , supplemented by a book on back pain care . Results . Participants r and omly assigned to the self‐management groups reported significantly less worry about back pain and expressed more confidence in self‐care . Rol and Disability Question naire Scores were significantly lower among participants in the self‐management groups relative to the usual care controls at 6 months ( P = 0.007 ) , and this difference was sustained at 12 months at borderline significance levels ( P = 0.09 ) . Among self‐management group participants , 48 % showed a 50 % or greater reduction in Rol and Disability Question naire Score at 6 months , compared with 33 % among the usual care controls . Conclusions . Self‐management groups led by trained lay persons following a structured protocol were more effective than usual care in reducing worries , producing positive attitudes toward self‐care , and reducing activity limitations among patients with back pain in primary care OBJECTIVE To determine the effectiveness of self-management education and physical training in decreasing fibromyalgia ( FMS ) symptoms and increasing physical and psychological well being . METHODS A pretest-posttest control group design was used . Ninety-nine women with FMS were r and omly assigned to 1 of 3 groups ; 86 completed the study . The education only group received a 6-week self-management course . The education plus physical training group received the course and 6 h of training design ed to assist them to exercise independently . The control group got treatment after 3 months . RESULTS The experimental programs had a significant positive impact on quality of life and self-efficacy . Helplessness , number of days feeling bad , physical dysfunction , and pain in the tender points decreased significantly in one or both of the treated groups when retested 6 weeks after the end of the program . Longterm followup of 67 treated subjects showed significant positive changes on the Fibromyalgia Impact Question naire primarily in the physical training group . Among all subjects , 87 % were exercising at least 3 times/week for 20 min or more ; 46 % said they had increased their exercise level since participating in the program ; 70 % were practicing relaxation strategies as needed ; 46 % were working at least half time as opposed to 37 % at pretest . CONCLUSION Self-efficacy of the treated groups was enhanced significantly by the program . Other changes were smaller and more delayed than had been expected . Recommendations for future trials include a longer education program , more vigorous physical training , and longterm followup Background In light of health disparities and the growing prevalence of chronic disease , there is a need for community-based interventions that improve health behaviors and health status . These interventions should be based on existing theory . Objective This study aim ed to evaluate the health and utilization outcomes of a 6-week community-based program for Spanish speakers with heart disease , lung disease , or type 2 diabetes . Method The treatment participants in this study ( n = 327 ) took a 6-week peer-led program . At 4 months , they were compared with r and omized wait-list control subjects  ( n = 224 ) using analyses of covariance . The outcomes for all the treatment participants were assessed at 1 year , as compared with baseline scores ( n = 271 ) using t-tests . Results At 4 months , the participants , as compared with usual-care control subjects , demonstrated improved health status , health behavior , and self-efficacy , as well as fewer emergency room visits ( p < .05 ) . At 1 year , the improvements were maintained and remained significantly different from baseline condition . Conclusions This community-based program has the potential to improve the lives of Hispanics with chronic illness  while reducing emergency room use & NA ; Although chronic pain is a frequent cause of suffering and disability and is costly to society , there continues to be limited access to specialty pain clinic services . Hence , there is a need for cost‐effective , accessible interventions that will help people find ways to better manage this difficult problem . This r and omized controlled trial examined the effect of a low‐cost , community‐based , nurse‐delivered , group psychoeducation program entitled the Chronic Pain Self‐Management Program ( CPSMP ) . It has a st and ard protocol that was modified from the successful Arthritis Self‐Management Program ( ASMP ) . One hundred and ten individuals with mixed idiopathic chronic pain conditions were enrolled in the study ( 75 % female ; mean age 40 years ; mean chronicity 6 years ) and were r and omly assigned to one of two conditions : the 12‐h ( CPSMP ) intervention group , or the 3‐month wait‐list control group . Self‐report measures of pain‐related and other quality of life variables as well as two hypothesized mediating variables were collected pre‐treatment and 3 months later by assessors blind to group allocation . One hundred and two subjects completed the study . Results of intention‐to‐treat analysis indicated that the treatment group made significant short‐term improvements in pain , dependency , vitality , aspects of role functioning , life satisfaction and in self‐efficacy and re source fulness as compared to the wait‐list control group . Because it has a st and ard protocol , this intervention has the potential to be reliably delivered at low cost in varied urban and rural community setting s and hence be more widely accessible to a greater number of people suffering from chronic pain than is currently the case with more specialized pain clinic services . Based on the results of this study , further research evaluating the long‐term impact and potential cost savings to the individual and to the health care system is warranted OBJECTIVE To assess the sustainable benefits of a professional , multidisciplinary training program for patients with rheumatoid arthritis . DESIGN Two studies with different observation periods . Study I was a prospect i ve , r and omized trial for 1 year . Study II was a noncontrolled observation over 5 years . SETTING The 9-day program for eight patient groups encompassed a multidisciplinary cooperation between rheumatologists , orthopedists , physicotherapists , psychologists and social workers . PATIENTS Sixty-eight consecutive patients with rheumatoid arthritis participated in an arthritis training program  either immediately after enrollment in the program or after 1 year . INTERVENTIONS The program covered the following fields : pathogenesis of rheumatoid arthritis , drug therapy , physicotherapy , practical exercise in remedial gymnastics , use of joint protection devices , orthopedic perspectives , psychological counseling , dietetics , information about unproven cures and social assistance . MAIN OUTCOME MEASURES Clinical outcome was assessed by self-report question naires : ( 1 ) Stanford Health Assessment Question naire , ( 2 ) Freiburg Question naire of Coping with Illness , ( 3 ) Beck Depression Inventory , and ( 4 ) a 21-point scale to evaluate cognitive-behavioral and environmental impact . RESULTS A significant and persistent improvement of all investigated parameters was demonstrated in the 1-year controlled trial . Between the end-point of the 1-year study and the 5-year evaluation , this improvement increased even more for functional status and coping with illness , whereas depression returned to baseline values . These effects were seen even without reinforcement of the training . CONCLUSION A professional , multidisciplinary approach to educate patients with rheumatoid arthritis leads to a significant and sustained improvement of the clinical outcome and is an approach that should be established as a part of conventional therapy OBJECTIVES To determine 4-month and 1-year health-related outcomes of a 6-week , lay-led , and community-based arthritis self-management program for Spanish-speaking participants and to determine the role of self-efficacy in predicting health status for this population . METHODS Three hundred and thirty one subjects were r and omized to the program or to a 4-month wait list control group . One hundred ninety eight subjects continued in a 1-year longitudinal study . Data were collected via mailed question naires with telephone follow up . RESULTS At 4 months , treatment subjects , compared with controls , demonstrated positive changes in exercise , disability , pain , and self-efficacy ( P < 0.05 ) . At 1 year , compared with baseline , treatment subjects demonstrated improvements in exercise , general health , disability , pain , self-efficacy , and depression ( P < 0.05 ) . Baseline and 4-month changes in self-efficacy predicted health status at 1 year . CONCLUSIONS Spanish-speaking participants of an arthritis self-management program demonstrate short- and long-term benefits ( improved health behaviors , health status , and self-efficacy ) BACKGROUND Reducing the impact of chronic disease in minority ethnic groups is an important public health challenge . Lay-led education may overcome cultural and language barriers that limit the effectiveness of professionally-led programmes . We report the first r and omised trial of a lay-led self-management programme - the Chronic Disease Self-Management Programme ( CDSMP ) ( Expert Patient Programme ) - in a south Asian group . AIM To determine the effectiveness of a culturally-adapted lay-led self-management programme for Bangladeshi adults with chronic disease . DESIGN OF STUDY R and omised controlled trial . SETTING Tower Hamlets , east London . METHOD We recruited Bangladeshi adults with diabetes , cardiovascular disease , respiratory disease or arthritis from general practice s and r and omised them to the CDSMP or waiting-list control .  Self-efficacy ( primary outcome ) , self-management behaviour , communication with clinician , depression scores , and healthcare use were assessed by blinded interviewer-administered question naires in Sylheti before r and omisation and 4 months later . RESULTS Of the 1363 people invited , 476 ( 34 % ) agreed to take part and 92 % ( 439/476 ) of participants were followed up . The programme improved self-efficacy ( difference : 0.67 , 95 % confidence interval [ CI ] = 0.08 to 1.25 ) and self-management behaviour ( 0.53 ; 95 % CI = 0.01 to 1.06 ) . In the 51 % ( 121/238 ) of intervention participants attending three or more of the 6-weekly education sessions the programme led to greater improvements in self-efficacy ( 1.47 ; 95 % CI = 0.50 to 1.82 ) and self-management behaviour ( 1.16 ; 95 % CI = 0.50 to 1.82 ) , and reduced HADS depression scores ( 0.64 ; 95 % CI = 0.07 to 1.22 ) . Communication and healthcare use were not significantly different between groups . The programme cost pound123 ( 181 ) per participant . CONCLUSION A culturally-adapted CDSMP improves self-efficacy and self-care behaviour in Bangladeshi patients with chronic disease . Effects on health status were marginal . Benefits were limited by moderate uptake and attendance OBJECTIVE To evaluate the effectiveness of Stanford 's Chronic Disease Self-Management Program ( CDSMP ) for chronic low back pain ( LBP ) in older Americans . DESIGN R and omized controlled trial . SETTING Community-based program offered at 12 locations . SUBJECTS Community-dwelling seniors ( n = 109 ) aged 60 and older with chronic LBP of mechanical origin . METHODS Patients were r and omly allocated to the CDSMP or to a 6-month , wait-list control group . The program included one 2.5-hour session per week for 6 weeks . Outcomes evaluated at 6 months included 100-point modified Von Korff pain and disability scales ; days with pain and disability ; SF-36 general health , energy-fatigue , and emotional well-being scales ; 2 scales from the Arthritis Self-Efficacy Scale , self-care attitudes/behaviors , and health services utilization . RESULTS For pain at 6 months , the primary outcome , the adjusted mean difference between the program and control , was -1.0 ( P = .835 ) . There was a sizable advantage for the program in disability averaged over the course of the entire 6-month study ( -9.2 , P = .027 ) , but not at the 6-month follow-up ( -5.8 , P = .278 ) . There was an interaction between intervention and baseline disability days favoring the program for higher baseline values ( P = .007 ) . The CDSMP affected emotional well-being ( 7.6 , P = .037 ) and energy-fatigue ( 5.1 , P = .274 ) . There were no differences for self-efficacy , pain days , and general health . CONCLUSION There was no advantage for the CDSMP over a wait-list control for improving pain , general health , self-efficacy , and self-care attitudes in older Americans with chronic LBP . A benefit was suggested for emotional well-being , fatigue , functional disability , and days with disability OBJECTIVE Evaluation of a self-management program for patients with osteoarthritis ( OA ) of the hip or knee . The program , which consisted of 6 weekly sessions of 2 hours , included health education by a peer and physical exercises taught by a physical therapist . METHODS R and omized controlled trial . Inclusion criteria were diagnosis of OA of the hip or knee according to ACR clinical and radiographic criteria and age 55 to 75 years . EXCLUSION CRITERIA on waiting list for joint replacement . There were pretest , posttest , and followup ( 6 months ) assessment s. The experimental group consisted of 56 patients , the control group 49 . Outcome variables were pain , quality of life , activity restrictions , knowledge about OA , self-efficacy , body mass index ( BMI ) , and mobility measures . Attention was also paid to effects on health care utilization and lifestyle behavior . RESULTS Significant MANOVA group x time effects ( p < 0.05 , one-sided ) were found for pain , quality of life , strength of the left M. quadriceps , knowledge , self-efficacy , BMI , physically active lifestyle , and visits to the physical therapist . Most effects were moderate at posttest assessment and smaller at followup . No effects were found for range of motion and functional tasks . CONCLUSION The program was reasonably effective , but more attention should be paid to proactive followup interventions and to the selection of participants This paper presents findings from the evaluation of a self-management education program based on self-regulation principles . Older men and women ( N = 324 ) were r and omly assigned to program and control groups . Outcomes were measured using the Sickness Impact Profile . Twelve months following baseline data collection , psychosocial functioning of program participants was significantly better than that of controls . Different program effects were noted when results were analyzed by participant gender Patients with rheumatoid arthritis must learn to adjust their exercise , rest and medication to the varying activity of the disease . Patient education can help patients in making the right decisions about adjustments in their treatment regimen and in attaining " self-management " behaviors . We developed a group education program based on social learning theory and the ' Arthritis Self-Management Course ' developed in the USA by Lorig . Goal of the program is the strengthening of self-efficacy , outcome expectations and self-management behaviors of RA patients which may lead to better health status . The program has been evaluated in an experimental design . We established significant positive effects of the group training on functional disability , joint tenderness , practice of relaxation and physical exercises , self-management behavior , outcome expectations , self-efficacy function and knowledge . After 14 months we still found effects on practice of physical exercises , self-efficacy function and knowledge
Purpose To carry out a systematic review of program outcomes used in the evaluation of  group-based self-management interventions  aim ed at people with arthritis and other chronic conditions .