Cited by 151Musculoskeletal pain and rehabilitationMusculoskeletal Disorders and RehabilitationRheumatoid Arthritis Research and Therapies

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Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions.

Lorig, Kate R., Ritter, Philip L., Laurent, Diana D., Fries, James F.·2004·Medical Care

DOI 10.1097/01.mlr.0000118709.74348.65

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Abstract

OBJECTIVE: The objective of this study was to test the effectiveness of a mail-delivered, tailored self-management intervention (SMART) and to compare it with the classic Arthritis Self-Management Program (ASMP). METHODS: We performed 2 randomized controlled trials: 1) a study of 1090 participants randomized to SMART or USUAL CARE, and 2) a study of 341 participants randomized to SMART or ASMP. Dependent variables included disability, pain, depression, role function, global severity, doctor visits, and self-efficacy. SMART interventions were provided in months 0-18 and not reinforced. Results were assessed at 1, 2, and 3 years using analyses of covariance (ANCOVA). RESULTS: Compared with USUAL CARE, SMART participants at 1 year had decreased disability, improved role function, and increased self-efficacy (all P <0.01). At 2 years, decreases in global severity, doctor visits, and increases in self-efficacy (all P <0.01) were noted. At 3 years without reinforcement, no statistically significant effects remained. Compared with ASMP, SMART at 1 year had greater decreases in disability (P = 0.02) and increases in self-efficacy (P = 0.01). There were no differences at 2 years. At 3 years, role function (P = 0.04) and doctor visit (P = 0.03) were improved in ASMP as compared with SMART. Improvements from baseline were seen for nearly all variables in both groups. CONCLUSIONS: A mail-delivered arthritis self-management program, SMART, was similarly effective to the classic ASMP, with slightly better results in the first year and a slightly more rapid attenuation over the next 2 years. Results suggest that both programs are effective, and that the addition of a mail-delivered program could improve accessibility to arthritis self-management treatment.

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Authors: Lorig, K. R., Ritter, P. L., Laurent, D. D., & Fries, J. F.
Affiliations: Stanford Medicine (US)
ORCID: Lorig, Kate R.
Ritter, Philip L.
Laurent, Diana D.
Venue: Medical Care
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2004-04
Volume: 42
Issue: 4
Pages: 346-354
ISSN: 0025-7079 (ISSN-L)
DOI: 10.1097/01.mlr.0000118709.74348.65
OpenAlex: W2039553066
Cited by: 151
References: 30
Citations by year: 2026: 1 · 2025: 1 · 2024: 6 · 2023: 1 · 2022: 1 · 2021: 4 · 2020: 4 · 2019: 4 · 2018: 5 · 2017: 3 · 2016: 8 · 2015: 8 · 2014: 9 · 2013: 6 · 2012: 13
FWCI: 5.86
Type: journal article
Language: en
Open access: closed
Locations: Medical Care (publishedVersion)
PubMed (publishedVersion)
Funders: National Institute of Arthritis and Musculoskeletal and Skin Diseases (AR-43584, P01AR043584)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Rehabilitation › Musculoskeletal Disorders and Rehabilitation
Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
Keywords: arthritis self-management, small group intervention, disability, self-efficacy, role functioning, pain, depression, physician visits, long-term effectiveness
MeSH terms: Activities of Daily Living, Adult, Aged, Aged, 80 and over, Analysis of Variance, Arthritis, Female, Health Status, Humans, Longitudinal Studies, Male, Middle Aged, Patient Education as Topic, Quality of Life, Surveys and Questionnaires, Self Care, Self-Help Groups, Severity of Illness Index, Teaching Materials, Program Evaluation, Outcome Assessment, Health Care, Self Efficacy

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Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions.

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