Patient Education In the Department of Medicine

Arthritis Self-Management Program

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The Arthritis Self-Management Program, also known as the Arthritis Self-Help Course, was our first patient education program, and the prototype for all our other programs. It is a workshop given two hours, once a week, for six weeks, in community settings such as senior centers, churches, libraries and hospitals. People with different types of rheumatic diseases, such as osteoarthritis, rheumatoid arthritis, fibromyalgia, lupus, and others, attend together. Workshops are facilitated by two trained leaders, one or both of whom are non-health professionals with arthritis themselves.

Subjects covered include: 1) techniques to deal with problems such as pain, fatigue, frustration and isolation, 2) appropriate exercise for maintaining and improving strength, flexibility, and endurance, 3) appropriate use of medications, 4) communicating effectively with family, friends, and health professionals, 5) healthy eating, 6) making informed treatment decisions, 7) disease related problem solving, and 8) getting a good night's sleep.

Each participant in the workshop receives a copy of the companion book, The Arthritis Helpbook, 6th Edition, and an audio relaxation tape, Time for Healing.*

It is the process in which the program is taught that makes it effective. Classes are highly participative, where mutual support and success build the participants’ confidence in their ability to manage their health and maintain active and fulfilling lives.

How was the Program developed?

The Arthritis Self-Management program was developed and evaluated during several randomized, controlled research projects, beginning in 1979. Most of the research was funded by the National Institutes of Health. The purpose of the research was to develop and evaluate, through a randomized controlled trial, a community-based self-management program that assists people with arthritis.

The process of the program was based on the experience of the investigators and others with self-efficacy, the confidence one has that he or she can master a new skill or affect one’s own health. The content of the workshop was the result of focus groups with people with arthritis, in which the participants discussed which content areas were the most important for them.

How was the Program evaluated?

In the late 1970's the ASMP was developed and evaluated in a 4-month randomized trial. A decade of research and fine-tuning the program followed at Stanford. It has also been evaluated by a number of well-controlled studies by multiple groups in different settings with different ethnic groups around the world.

What were the results?

Subjects who took the Program, when compared to those who did not, ASMP participants reduced their pain, sometimes reduced disability, improved quality-of-life, and reduced utilization of medical services. These benefits lasted for at least four years.** The Arthritis Self-Management Program (ASMP) was endorsed and recommended by the Centers for Disease Control, the Arthritis Foundation, and the American College of Rheumatology.

How can my facility offer the Program?

Leader trainings for representatives of health care organizations who have not previously been trained in the Chronic Disease Self-Management Programare are 5 days (4 days for CDSMP and then a 1 day cross-training in ASMP). Contact if you are interested in training at your facility.

If your organization has active leaders for the CDSMP, they can be cross-trained for ASMP by Stanford webinar. See the Cross-Training page for more information about web-based cross-training.

 

*For information about these materials, see our Materials page.

**Outcome data reported in:

Lorig K, Mazonson P, Holman HR: Evidence suggesting that health education for self-management in patients with chronic arthritis has sustained health benefits while reducing health care costs. Arthritis and Rheumatism, 36(4):439-446, 1993.

Lorig K, Lubeck D, Kraines RG, Seleznick M, Holman HR: Outcomes of self-help education for patients with arthritis. Arthritis and Rheumatism, 28(6):680-685, 1985.

Lorig K, González VM, and Ritter P. Community-based Spanish language arthritis education program: a randomized trial. Medical Care, 37(9):957-963,1999.

For more articles, see Bibliography.

Stanford Medicine Resources:

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