Osteoarthritis improves with self-management program

Patients who participated in a cognitive-behavioral-based program to help manage their arthritis had sustained improvements in pain and daily functioning in Osteoarthritis of the hip or knee, Dutch investigators report in the Journal of Rheumatology.

The intervention involved six 2-hour sessions led by two physiotherapists, during which patients were taught goal-setting to optimize activity levels, self-relaxation for pain control, self-diagnostic skills and problem solving.

The 273 patients, ages 40 to 60 years, in the study were randomly assigned to self-management or to the usual care by a family physician or specialist.

After 3 months, Dr. Peter H. T. G. Heuts, at the Rehabilitation Foundation in Limburg, and his colleagues documented an average decrease in knee pain of 0.67 points on a pain severity scale in the intervention group versus virtually no change in the group assigned to the usual care.

Scores on two questionnaires that measured functional status revealed an average improvement of 2.45 points in the self-management group, versus a deterioration of 0.53 points in the usual care group. Similar results were observed in the patient-specific functional status score.

Differences between groups were even more pronounced after 21 months, the authors report.

"Improvement of pain and daily functioning in this group evidently has important consequences," Heuts' group notes, "because it positively influences opportunities for active social participation and quality of life."

They conclude that "broader implementation of this intervention in primary care settings is warranted."

SOURCE: Journal of Rheumatology, March 2005.