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

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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.

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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.


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.

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Correspondence to Ying-Ying Leung.

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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).

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