Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Effects of a Telephone Based Osteoarthritis Self-Management Program on Communication with Health Care Providers.
Allen1, Kelli D., Bosworth1, Hayden B., Coffman1, Cynthia, Lindquist1, Jennifer H., Sperber1, Nina R., Weinberger2, Morris, Oddone1, Eugene Z.
Osteoarthritis (OA) self-management programs aim to improve patients' communication with health care providers about their OA and its treatment, but little is known about how effectively these programs meet this goal. These analyses examined whether a telephone-based OA self-management program improved patients' self-reported communication with providers and perceptions of participation in OA treatment decisions. We also examined whether there were differential program effects according to patient race and education level, since these characteristics have been associated with differences in communication with providers.
Participants (n=515, mean age = 60 years, 93% male, 46% non-white-primarily African American) were involved in a randomized controlled trial of a telephone-based OA self-management program, compared to health education (HE; attention control) and usual care control (UC) groups. The self-management program included education materials and 12 monthly calls from a health educator to facilitate personal goals for OA management. Outcomes for these analyses, collected at baseline and 12-month follow-up, included the Communication with Physicians Scale (CPS; range 05, higher scores indicate more active communication behaviors such as discussing OA-related problems) and the Medical Outcomes Survey Participatory Decision-Making Scale (PDMS; range 0100, higher scores indicate greater participation). Linear mixed modeling was used to assess differential improvement in CPS and PDMS scores between the OA arm and control arms (HE and UC), between white vs. non-white participants and participants with some college vs. no college.
At baseline mean CPS and PDMS scores were higher for those with some college than those with no college (2.6 vs. 2.2; p<0.01 and 77.4 vs. 72.5;p=0.05) There were no overall intervention effects on change in CPS scores over 12-months and no differences in change by race. However, compared with the UC group, OA intervention effects on CPS differed according to education (p=0.03). In the OA group, CPS scores improved by 0.4 points for those with no college education compared to 0.1 points for those with some college education. There were no overall intervention effects on change in PDMS scores and no differences in effects according to education. However, there were differences in OA intervention effects on PDMS according to race, compared with both HE (p=0.04) and UC (p=0.06) groups. In the OA self-management group, whites improved by 7.5 points, whereas non-whites declined by 4.3 points. In both the HE and UC arms there were small improvements in PDMS scores for both whites and non-whites.
Patients in this OA self-management program who had lower education levels improved in their self-reported communication with physicians about their OA (about a 20% increase in score), and this is a key demographic group for targeting these programs. Non-whites' decline in participatory decision-making scores may be due to a change in perception of how actively they participate in OA treatment decisions; a more robust intervention may be needed to increase participatory behaviors.
To cite this abstract, please use the following information:
Allen, Kelli D., Bosworth, Hayden B., Coffman, Cynthia, Lindquist, Jennifer H., Sperber, Nina R., Weinberger, Morris, et al; Effects of a Telephone Based Osteoarthritis Self-Management Program on Communication with Health Care Providers. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1582