Crotty and coworkers evaluated the efficacy of a self-management support program including a six-week self-management course, individualized phone support, and goal setting in osteoarthritis patients on a waiting list for arthroplasty surgery. The study was a randomized controlled trial of 152 public hospital outpatients awaiting hip or knee replacement surgery who were not classified as requiring urgent surgery. Participants were randomized to a self-management program or to usual care. The primary outcome was change in the Health Education Intervention Questionnaire (HeiQ) from randomization to six-month follow-up. Quality of life and depressive symptoms were also measured. Changes in pain and function were assessed using the Western Ontario and McMaster Universities (WOMAC) Arthritis Index. At the six-month follow-up, health-directed behavior was significantly greater in the intervention than the control. There was also a significant effect on skill and technique acquisition for the intervention in comparison to control. There was no significant effect of the intervention on the remaining HeiQ subscales, WOMAC pain or disability, quality of life, or depressive symptoms.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The arthritis self-management program improved health-directed behaviors, skill acquisition and stiffness in patients on a joint replacement waiting list, although the observed effects were of modest size. There was no significant effect on pain, function, or quality of life in the short term. Self-management programs can assist in maintaining health behaviors (particularly walking) in this patient group.

WHAT THE STUDY COULD MEAN TO YOU AS A PATIENT: Self-management training is a staple in the control of arthritis. There were only modest gains in the present study, but more robust findings are usually found in self-management programs for the condition. If you experience arthritis, ask your health care provider for available self-management programs in your area. The acquisition and performance of such skills will help you improve your condition.

M Crotty et al. Self-management and peer support among people with arthritis on a hospital joint replacement waiting list: a randomized controlled trial. Osteoarthritis & Cartilage, May 21, 2009.