Simple approaches improve arthritis self-management programs

A recent study describes reasons for the limited success of group-based rheumatoid arthritis (RA) self-management programs and proposes strategies to address these factors. Twenty patients who had recently participated in group self-management programs underwent semi structured interviews to elucidate, from a patient’s perspective, why there was only limited success of these programs. In keeping with previous findings, the authors report that the programs concerned had generally failed to produce significant improvement in patients' ability to manage their disease. This was primarily because patients were not very interested in attending the program and lacked motivation to change their behaviour to improve their disease state. Approximately 50% of patients reported positive internal forces motivating them to attend program sessions. Patients were also more likely to be disappointed with the program because of deteriorating health or stressful events during its course. The authors propose three strategies to improving effects of self management programs; (a) provide information about the program in advance to ensure that patients have appropriate expectations. (b) Enhance counselling techniques to improve levels of motivation and change health behaviour. (c) Tailor the program to better suit the patients level of motivation and current concerns around their condition. The authors suggest, "One option would be to group patients according to their concerns and provide them with individual tailored information, tasks, and exercises via the computer and let them interact online with patients in similar conditions to ensure peer support." Reference Bode, C. Taal, E. Emons, P. et al. 2008, ‘Recent findings indicate reasons that a lack of motivation is key to the limited success of group-based rheumatoid arthritis (RA) self-management programs.’ Clinical Rheumatology, Online First. Volume and edition to be announced....