SELF-MANAGEMENT
Education, relaxation techniques, weight loss, stress reduction, motivation, and social support can help patients manage their symptoms, adhere to treatment regimens, and live with the consequences of a chronic condition. These interventions can be delivered in a variety of formats (online or in groups, for example). A recent analysis I conducted with my colleagues summarized the data from eight studies that examined self-management for people with OA.31 Most of the studies enrolled subjects with hip or knee OA or both. The interventions varied—most group interventions took place in 12 hours spread over a six- week period, while individual interventions lasted one hour—and examined pain and function as out- comes, although some also assessed health knowledge, care use, and self-efficacy; mood and fatigue were infrequently assessed. Overall, only half of the studies found significant long-term (12 months or more) improvements in function and pain; two noted significant improvements in self-efficacy, and one reported improved mood. Group interventions appeared to have greater impact on outcomes than individual sessions did. The most effective interventions consisted of standardized group sessions, including six weeks of supervised exercise, led by trained people and using either cognitive behavioral therapy or theoretical behavioral approaches. [Editor’s note: See “Strategies to Support Self-Management in Osteoarthritis” in this supplement.]