Self-management (SM) programs are effective for many chronic conditions, although the evidence for osteoarthritis SM is inconclusive. The aim of a case series project by Coleman and coworkers was to determine whether a newly developed specific SM program for people with osteoarthritis of the knee, implemented by health professionals, could achieve and maintain clinically meaningful improvements. There were 79 participants enrolled in the study; their mean age was 66 years, with established osteoarthritis of the knee. People with coexisting inflammatory joint disease or serious co-morbidities were excluded. The intervention consisted of a 6-week disease and site (knee) specific self-management education program that included disease education, exercise advice, information on healthy lifestyle, and relevant information within the constructs of self-management. The program was conducted in a community health care setting and delivered by health professionals. Measures of pain, physical function, and mental health scales were assessed at baseline, 8-weeks, 6- and 12-months using WOMAC and SF-36 questionnaires. Changes in pain during the 8-week intervention phase were monitored. Pain improved during the intervention phase: mean (95% CI) change 15 (8 to 22) mm. Improvements (0.3 to 0.5 standard deviation units) in indices of pain, mental health, and physical functioning, assessed by SF-36 and WOMAC questionnaires, were demonstrated from baseline to 12 months.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that their disease and site-specific self-management education program improved health status of people with osteoarthritis of the knee both in the short and medium term.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: Considerable research on self-management programs for arthritis has emerged in the past two decades. Anyone with either osteoarthritis or rheumatoid arthritis should learn self-management skills. Ask your health care provider to refer you to an established program or strongly suggest that he or she initiate such self-management training for you and others with your condition. There are programs available, such as that developed by Kate Lorig and her colleagues at Stanford, that can fit into any medical setting.

S Coleman et al. Short and medium-term effects of an education self-management program for individuals with osteoarthritis of the knee, designed and delivered by health professionals: a quality assurance study. BMC Musculoskeletal Disorders, 2008;9:117.