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Patient education and self-management of musculoskeletal diseases

https://doi.org/10.1016/j.berh.2008.02.006Get rights and content

The research literature reports that patient (consumer) education and self-management programs and practices help people with chronic disease live better lives by improving health outcomes and psycho-emotional and psychosocial measures. However, arthritis charities that offer self-management programs in the United Kingdom, the United States and Canada anecdotally report significant drops in enrollment, and emerging data suggest that these types of programs are not a panacea for people attending them. This chapter will provide the reader with the following: an introduction to patient education and self-management; a discussion on participation rates in patient education and arthritis self-management programs; an overview of the ‘state-of-the-art’ in patient education and self-management programs; new ideas on patient education delivery models; tips on improving physician–patient communication; and suggested areas of research required to advance the area of patient education and self-management.

Section snippets

Participation in arthritis self-management programs

The recognition of the substantial and increasing burden of arthritis on health-care resources led to three arthritis self-management objectives being added to the US national health objectives for 2010. One of these was arthritis education, and the other two were weight counseling and physical activity counseling.3, 4 Given the importance placed on arthritis education in the context of the US health-care agenda, it may be helpful to ask: how many with the disease are receiving education

A look at the ‘state-of-the-art’ in arthritis patient education and self-management

Education is the ‘portal’ through which a person with arthritis must go to achieve successful self-management. If they do not have a good understanding of the disease – what the course of it will look like over their life-time if untreated or under treated, what types of health behavior and support are helpful and unhelpful – then it will be difficult for them to know what they have to ‘manage’. The ideal time for a person to pass through the education portal is at the earliest formal stage of

New ideas on patient education and self-management

To build on the ‘times are changing’ theme, it is time to experiment with new ideas on development and delivery of patient education and self-management programs: ones that are customized to meet the needs of the individual, not the masses. Just like in medication therapies, programs need to be tailor-made and delivered in a timely manner and at very low cost given the growing need.

Examples of new programming might include the following.

  • Audio programming (or ‘podcasts’)35 downloadable to

Conclusions

Formal patient education and self-management interventions have been a disappointment. Short-term benefits have been modest, and long-term benefits have generally not been easy to demonstrate. In part, while ‘self-management’ has been a popular term, there has been remarkably little study of it. An intervention of comparable efficacy to self-management would be the use of analgesics or non-steroidal anti-inflammatory drugs, treatments that have attracted $100s of millions of research funding.

Acknowledgements

Dr. Esdaile is supported by a Kirkland Scholar Award funded by Rheuminations, Inc., a non-profit foundation dedicated to supporting research leading to the treatment and cure of lupus.

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