C Kett et al. Self-management strategies used during flares of rheumatoid arthritis in an ethnically diverse population. Musculoskeletal Care, August 26, 2010.

Effective management of flares of rheumatoid arthritis (RA) can improve symptoms and may delay disease progression. The practice of rheumatologists in managing a flare has been studied, but patients' experiences of, and responses to, disease flares remain poorly defined. Kett and associates study was aimed to explore this issue. Semi-structured interviews were conducted with 21 patients from an ethnically diverse population who had suffered a recent RA flare. Open questions were asked regarding patients' definitions of a flare, causal attribution, self-management strategies, their triggers to consult health professionals, and the information they had received about RA flares from health professionals. Transcripts were studied using the grounded theory approach to identify themes. Flares were usually described as worsening joint pain and swelling. Over-use of joints was identified as the most common cause of a flare, and commonly used self-management strategies included rest, gentle exercise, and warming the joints. There was some variation in causal attribution and self-management with ethnicity.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that they had identified a link between causal attribution of flares and the resultant self-management strategies. A perceived trigger of the flare in some patients formed a focus for their self-management strategies, whereas those who could not identify a cause aimed mainly to alleviate symptoms. A better understanding of patients' perspective in the context of disease flares will allow the development of educational programs to facilitate more effective self-management of this important manifestation of disease.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE CONSUMER:
The findings of the investigation may be useful to anyone designing and implementing a self-management program for rheumatoid arthritis. Equally important, the information gathered in the study could be applied, if it is not already, into one of the many successful self-management programs for rheumatoid arthritis.