Clinical Rheumatology

, Volume 32, Issue 1, pp 49–59 | Cite as

The effect of the Arthritis Self-Management Program on outcome in African Americans with rheumatoid arthritis served by a public hospital

  • Doyt L. Conn
  • Yi Pan
  • Kirk A. Easley
  • Dawn L. Comeau
  • Joyce P. Carlone
  • Steven D. Culler
  • Athan Tiliakos
Original Article


The purpose of the study was to determine the effect of the Arthritis Self-Management Program (ASMP) on a cohort of patients, primarily African American (90 %), with rheumatoid arthritis (RA) served by a public hospital. One hundred four patients were randomly assigned to the ASMP group or the usual care group and followed for 18 months. The primary endpoint was clinical improvement indicated by the American College of Rheumatology (ACR20). Focus groups were conducted to provide contextual data. The percentages of patients achieving ACR20 were similar in the ASMP (14 % at 18 months) and usual care (17 %) groups (p = 0.3). However, 28 % of the 25 ASMP patients that attended four or more classes achieved ACR 20 after 18 months of follow-up, but only 5 % of the 27 ASMP patients that attended less than four classes achieved ACR20 (P = 0.1). There was a reduction in the tender and swollen joints in both groups over time (P = 0.02), and those aged 60 and over had fewer joints involved. Half of the cohort fell at or below the poverty level. The percentages of patients achieving ACR20 were similar in the ASMP and usual care groups. Patients who attended four or more ASMP classes improved the most, but included only half of those assigned to ASMP. This suggests a need for innovative participant retention strategies or a different type of self-management program for this population.


African Americans Clinical outcomes Patient self-management Rheumatoid arthritis 



This study was supported by The Physicians Foundation Grant No. 9600564.




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Copyright information

© Clinical Rheumatology 2012

Authors and Affiliations

  • Doyt L. Conn
    • 1
  • Yi Pan
    • 2
  • Kirk A. Easley
    • 2
  • Dawn L. Comeau
    • 3
  • Joyce P. Carlone
    • 1
  • Steven D. Culler
    • 4
  • Athan Tiliakos
    • 1
  1. 1.Division of RheumatologyEmory University School of MedicineAtlantaUSA
  2. 2.Department of Biostatistics and Bioinformatics, Rollins School of Public HealthEmory UniversityAtlantaUSA
  3. 3.Department of Behavioral Sciences and Health Education, Rollins School of Public HealthEmory UniversityAtlantaUSA
  4. 4.Department of Health Policy and Management, Rollins School of Public HealthEmory UniversityAtlantaUSA

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