Skip to main content

Advertisement

Log in

A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

The objectives of this paper are to evaluate the efficacy of a community-based lay-led Arthritis Self-Management Program (ASMP) among patients with chronic inflammatory arthritis and evaluate the effectiveness of “shared care collaboration” between hospital and community. We trained 17 lay leaders and recruited patients with chronic inflammatory arthritis via a new shared-care model between hospital rheumatology centers and community organizations. Participants were allocated to interventional group or a wait list control group. Evaluations were completed before, after (6 weeks), and 3 months after ASMP. We performed analysis of covariance with adjustment with age, sex, marital status, education, employment, duration of illness, and disability at baseline. A total of 65 participants and 32 controls completed the study. The mean (SD) age and duration of illness were 52.0 (11.4) and 5.6 (7.3) years, 90.7 % were female, 80.4 % had rheumatoid arthritis; 25.8, 53.6, and 12.4 % referrals were from hospitals, community organizations, and patient self-help groups, respectively. The interventional group had significantly less pain (p = 0.049 at 6 weeks), used more cognitive coping methods (p = 0.008 at 6 weeks, p = 0.041 at 3 months) and practiced more aerobic exercise (p = 0.049 at 6 weeks, p = 0.008 at 3 months) after adjustment of covariance. The interventional group had a trend of improvement in self-efficacy, fatigue, self-rated health, and health distress. A community-based lay-led ASMP showed positive beneficial effects on participants with chronic inflammatory arthritis. Shared-care collaboration between hospitals, community organizations, and patient self-help groups was demonstrated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lorig K (2002) Partnerships between expert patients and physicians. Lancet 359:814–815

    Article  PubMed  Google Scholar 

  2. Lorig KR, Sobel DS, Stewart AL, Brown BW, Bandura A, Ritter P et al (1999) Evidence suggesting that a chronic disease management program can improve health status while reducing hospitalization: a randomized trial. Med Care 37:5–14

    Article  CAS  PubMed  Google Scholar 

  3. Riemsma RP, Kirwan JR, Taal E, Rasker JJ (2003) Patient education for adults with rheumatoid arthritis. Cochrane Database Syst Rev. 2:CD003688

  4. Donaldson L (2003) Expert patients usher in a new era of opportunity for the NHS. BMJ 326:1279–1280

    Article  PubMed  PubMed Central  Google Scholar 

  5. Barlow JH, Turner AP, Wright CC (2000) A randomized controlled study of the Arthritis Self-Management Programme in the UK. Health Educ Res 15:665–680

    Article  CAS  PubMed  Google Scholar 

  6. Harvey PW, Petkov JN, Misan G, Fuller J, Battersby MW, Cayetano TN et al (2008) Self-management support and training for patients with chronic and complex conditions improves health-related behaviour and health outcomes. Aust Health Rev 32:330–338

    Article  PubMed  Google Scholar 

  7. Foster G, Taylor SJC, Eldridge SE, Ramsay J, Griffiths CJ (2007) Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev 17:CD005108

  8. Lorig K, Holman H (1993) Arthritis self-management studies; a 12 year review. Health Educ Q 20:97–106

    Article  Google Scholar 

  9. Taylor D, Bury M (2007) Chronic illness, expert patients and care transition. Sociol Health Illn 29:27–45

    Article  PubMed  Google Scholar 

  10. Griffiths C, Motlib J, Azad A, Ramsay J, Eldridge S, Feder G et al (2005) Randomised controlled trial of a lay-led self-management programme for Bangladeshi patients with chronic disease. Br J Gen Pract 55:831–837

    PubMed  PubMed Central  Google Scholar 

  11. Fu D, Fu H, McGowan P, Shen YE, Zhu L, Yang H et al (2003) Implementation and quantitative evaluation of chronic disease self-management programme in Shanghai, China: randomized controlled trial. Bull World Health Organ 81:174–182

    PubMed  PubMed Central  Google Scholar 

  12. Lorig K, Gonzalez VM, Ritter P (1999) Community-based Spanish language arthritis education program: a randomized trial. Med Care 37:957–963

    Article  CAS  PubMed  Google Scholar 

  13. Lorig K, Fries J (2000) The arthritis helpbook a test self-management program for coping with arthritis and fibromyalgia, 5th edn.

  14. Bandura A (1989) Human agency in social cognitive theory. Am Psychol 44:1175–84

    Article  CAS  PubMed  Google Scholar 

  15. Yip YB, Sit JW, Fung KKY, Wong DYS, Chong SYC, Chung LH et al (2004) A quasi-experimental study on improving arthritis self-management for residents of an aged people’s home in Hong Kong. Psychol Health Med 9:249–260

    Article  Google Scholar 

  16. Yip YB, Sit JW, Fung KKY, Wong DYS, Chong SYC, Chung LH et al (2007) Impact of an arthritis self-management programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study. Patient Educ Couns 65:131–121

    Article  Google Scholar 

  17. Lorig K, Stewart A, Ritter P, González V, Laurent D, Lynch J (1996) Outcome measures for health education and other health care interventions. Sage, Thousand Oaks, CA

    Google Scholar 

  18. Fries JF, Spitz P, Kraines RG, Holman HR (1980) Measurement of patient outcomes in arthritis. Arthritis Rheum 23:137–145

    Article  CAS  PubMed  Google Scholar 

  19. Gonzales VM, Steward A, Ritter PL, Lorig K (1995) Translation and validation of arthritis outcome measures into Spanish. Arthritis Rheum 38:1429–1446

    Article  Google Scholar 

  20. Lorig K, Chastain RL, Ung E, Shoor S, Holman HR (1989) Development and evaluation of a scale to measure the perceived self-efficacy of people with arthritis. Arthritis Rheum 32:37–44

    Article  CAS  PubMed  Google Scholar 

  21. Goeppinger J, Lorig KR, Ritter PL, Mutatkar S, Villa F, Gizlice Z (2009) Mail-delivered arthritis self-management tool kit: a randomized trial and longitudinal followup. Arthritis Rheum 61:867–875

    Article  PubMed  Google Scholar 

  22. Osborne R, Wilson T, Lorig K, McColl G (2007) Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians. J Rheumatol 34:1112–1117

    PubMed  Google Scholar 

  23. Lam CL, Gandek B, Ren XS, Chan MS (1998) Tests of scaling assumptions and construct validity of the Chinese (HK) version of the SF-36 health survey. J Clin Epidemiol 51:1139–1147

    Article  CAS  PubMed  Google Scholar 

  24. Lam CLK, Tse EYY, Gandek B, Fong DYT (2005) The SF-36 summary scales were valid, reliable, and equivalent in a Chinese population. J Clin Epidemiol 58:815–822

    Article  PubMed  Google Scholar 

  25. Chui D, Lau J, Yau I (2004) An outcome evaluation study of the Rheumatoid Arthritis Self-Management Programme in Hong Kong. Psychol Health Med 9:286–292

    Article  Google Scholar 

  26. Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A et al (2001) Improving chronic illness care: translating evidence into action. Health Aff 20:64–78

    Article  CAS  Google Scholar 

  27. McGowan P, Lorig K (2007) The Delivery of Self-Management Interventions. In: Newman S, Steed L, Mulligan K (eds) Chronic Physical Illness: Self-Management and Behavioural Interventions. Open University Press, McGraw Hill, Berkshire England

    Google Scholar 

  28. Siu AMH, Chan CCH, Poon PKK, Chui DYY, Chan SCC (2007) Evaluation of the chronic disease self-management program in a Chinese population. Patient Educ Couns 65:42–50

    Article  PubMed  Google Scholar 

  29. Bower P, Kennedy A, Reeves D, Gately C, Lee V, Rogers A et al (2006) Recruitment to a trial of self-care skills training in long-term health conditions: analysis of the impact of patient attitudes and preferences. Contemp Clin Trials 27:49–56

    Article  PubMed  Google Scholar 

  30. Sobel D, Lorig K, Hobbs M (2002) Chronic condition self-management program: from development to dissemination. Permanente J 6:11–18

    Google Scholar 

  31. Lorig KR, Ritter PL, Laurent DD, Plant K (2002) Can a Back Pain E-mail Discussion Group improve health status and lower health care costs? A randomized study. Arch Intern Med 162:792–796

    Article  PubMed  Google Scholar 

  32. Lorig KR, Ritter PL, Laurent DD, Plant K (2008) The internet-based arthritis self-management program: a 1-year randomized trial for patients with arthritis or fibromyalgia. Arthritis Rheum 59:1009–1017

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We thank the staff in Community Rehabilitation Network of the Hong Kong Society of Rehabilitation for conduction of training of lay leaders and coordination work of the ASMP. We thank all the rheumatologists, specialty nurses, allied health professionals, and the four patient self-help groups (Hong Kong Ankylosing Spondylitis Association, B27 Association, Hong Kong Psoriatic Arthritis Association, and Hong Kong Rheumatoid Arthritis Association) for referral of cases to the program. We are also in debt to the lay leaders and participants of the program.

Funding

This study was supported by the Hong Kong Arthritis Foundation.

Disclosures and conflicts of interest

Ying-Ying Leung, none; Jackie Kwan, none; Patsy Chan, none; Peter KK Poon, none; Christine Leung, none; Lai-Shan Tam, none; Edmund K Li, none; Anna Kwok, none. We declare that all authors do not have a financial relationship with the Hong Kong Arthritis Foundation that sponsored this study. The authors have full control of the primary data.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ying-Ying Leung.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Leung, YY., Kwan, J., Chan, P. et al. A pilot evaluation of Arthritis Self-Management Program by lay leaders in patients with chronic inflammatory arthritis in Hong Kong. Clin Rheumatol 35, 935–941 (2016). https://doi.org/10.1007/s10067-014-2791-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-014-2791-z

Keywords

Navigation