FRIDAY, Oct. 13, 2006 (HealthDay News) -- "Self-care" programs that help patients manage osteoarthritis on their own reduced some of the anxiety associated with the condition but did not ease people's pain, boost their physical functioning, or decrease doctor visits, British researchers report.
Outside experts faulted the study for not having enough detail, however.
"While this is a large study, the paper doesn't clearly describe the experimental self-management intervention [used]. Not fully understanding what patients did confounds the interpretation of the findings," said Daniel S. Rooks, an assistant professor of medicine at the Center for the Study of Nutrition Medicine at Beth Israel Deaconess Medical Center, in Boston.
"I think the study is showing that there's not a lot of bang for the buck at this point, but this whole area is very worthwhile and just needs to be further explored," he said.
"I don't think this study completely answers the questions," added Dr. Mary Chavez, professor and chairwoman of pharmacy practice at Texas A & M Health Science Center's Irma Lerma Rangel College of Pharmacy. "It's a bigger study, but it did have limitations."
Researchers at the Royal Free and University College Medical School in London published their report in the Oct. 14 issue of the British Medical Journal.
Osteoarthritis, primarily a disease of aging, affects some 21 million adults in the United States and about 5 million people in the United Kingdom, where the study was conducted.
The notion of self-management of osteoarthritis is increasingly being promoted in the United States and elsewhere.
"People want to have their own self-care. They don't want to be dictated to," Chavez said. "It's also managed care [companies] -- they want to make people responsible for their own health, and they want something that's cost-effective." Diet and exercise, in particular, are increasingly advocated for people with this condition.
Previous studies on the issue had offered conflicting results, however.
This study involved 812 volunteers aged 50 and over with osteoarthritis in their hips and/or knees. Participants were divided into two groups, one of which was placed on a six-session arthritis self-management program and provided with an education booklet. The second group received only the education pamphlet.
Participants completed a questionnaire at the beginning of the trial, at the four-month point in the trial, and after one year.
People in the self-management program did show lowered anxiety levels than those in the pamphlet-only group. They also exhibited more confidence in their ability to manage their symptoms.
But there was little difference between the two cohorts when it came to pain, improved physical functioning or fewer doctors' visits, the research team found.
Chavez pointed out, however, that many people in the self-management group didn't attend all the educational sessions, meaning that any comparison may not be a valid one. It also wasn't entirely clear what pain medications participants were taking.
"This large study agrees with findings of several studies in the U.K. and U.S.A. that suggest that education and targeted patient information, delivered in a class (group) format, is mildly helpful to arthritis patients," Rooks said. "I agree that much more work needs to be done to further develop the potential of patient self-management interventions [but] it's much more complex than what some people might think. It's still an important area to pursue."
"This doesn't mean we should throw out self-care," Chavez said.
Dr. Robert W. Hoffman, director of the division of rheumatology and immunology at the University of Miami's Miller School of Medicine, agreed.
"Certainly self-management can play an important role and is advocated," he said.
More information
Learn more about arthritis and exercise from the U.S. National Institutes of Health.
