Document Detail


The effect of the Arthritis Self-Management Program on outcome in African Americans with rheumatoid arthritis served by a public hospital.
MedLine Citation:
PMID:  23053684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The purpose of the study was to determine the effect of the Arthritis Self-Management Program (ASMP) on a cohort of patients, primarily African American (90 %), with rheumatoid arthritis (RA) served by a public hospital. One hundred four patients were randomly assigned to the ASMP group or the usual care group and followed for 18 months. The primary endpoint was clinical improvement indicated by the American College of Rheumatology (ACR20). Focus groups were conducted to provide contextual data. The percentages of patients achieving ACR20 were similar in the ASMP (14 % at 18 months) and usual care (17 %) groups (p = 0.3). However, 28 % of the 25 ASMP patients that attended four or more classes achieved ACR 20 after 18 months of follow-up, but only 5 % of the 27 ASMP patients that attended less than four classes achieved ACR20 (P = 0.1). There was a reduction in the tender and swollen joints in both groups over time (P = 0.02), and those aged 60 and over had fewer joints involved. Half of the cohort fell at or below the poverty level. The percentages of patients achieving ACR20 were similar in the ASMP and usual care groups. Patients who attended four or more ASMP classes improved the most, but included only half of those assigned to ASMP. This suggests a need for innovative participant retention strategies or a different type of self-management program for this population.
Authors:
Doyt L Conn; Yi Pan; Kirk A Easley; Dawn L Comeau; Joyce P Carlone; Steven D Culler; Athan Tiliakos
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2012-09-29
Journal Detail:
Title:  Clinical rheumatology     Volume:  32     ISSN:  1434-9949     ISO Abbreviation:  Clin. Rheumatol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-01-30     Completed Date:  2013-07-16     Revised Date:  2013-10-21    
Medline Journal Info:
Nlm Unique ID:  8211469     Medline TA:  Clin Rheumatol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  49-59     Citation Subset:  IM    
Affiliation:
Division of Rheumatology, Emory University School of Medicine, Atlanta, GA, USA. conn@emory.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
African Americans / ethnology*
Aged
Arthritis, Rheumatoid / ethnology*,  physiopathology,  rehabilitation*
Cohort Studies
Female
Georgia / epidemiology
Humans
Hyperalgesia
Joints / pathology,  physiopathology
Male
Middle Aged
Program Evaluation*
Quality of Life
Recovery of Function
Self Care / methods*
Treatment Outcome
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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