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Does Arthritis Self-management Help? A Randomised Controlled Trial of an Arthritis Self-Management Programme in Primary Care
The  Trial ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Contents of Presentation   ,[object Object],[object Object],[object Object],[object Object],[object Object]
Background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Previous results from studies examining arthritis self- management programmes in the USA & UK ,[object Object],[object Object],[object Object],[object Object],[object Object]
Arthritis Self-Management Programmes (ASMPs) ,[object Object],[object Object],[object Object],[object Object]
“ Challenging Arthritis”   (ASMP delivered by Arthritis Care) ,[object Object],[object Object],[object Object],[object Object],[object Object]
‘ Expert Patients’ Initiative ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Study Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object]
Study Design ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Inclusion  &  Exclusion Criteria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Outcomes to be Measured ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Patient Identification  & Recruitment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Qualitative methodology ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Collaboration with  the Voluntary Sector ,[object Object],[object Object],[object Object],[object Object]
Arthritis Care   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Analysis Plan ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Results - recruitment
Results – baseline characteristics   Intervention   n=406 Control   n=406 Age  (yrs)  Mean  (S.D.)   68.4 (8.2 ) 68.7  (8.6) Gender  Female   255 (62.8%) 255 (62.8%) Owner Occupier 323 (82.6%) 302 (78.6%) Ethnicity  White   388 (99.5%) 382 (99.2%) Age left school  < 16 years 249 (63.8%) 259 (67.6%) Higher education   107 (27.6%) 102 (26.7%)
Results – Challenging Arthritis course attendance ,[object Object],[object Object]
OUTCOMES Adjusted difference in means & (95% C.I.) at 4 months Adjusted difference in  means & (95% C.I.) at  12 months SF 36 MENTAL HEALTH  Intention to Treat (ITT) Per protocol analysis   0.11 (-1.18,1.40) 0.82 (-0.94,2.57)   1.35 (-0.03, 2.74) 1.56 (- 0.28, 3.39) SF 36 PHYSICAL HEALTH  Intention to Treat (ITT) Per protocol analysis    0.22 (-1.5, 1.94)  - 0.37 (-2.02,1.28)   0.33 (- 1.31, 1.98) 0.24 (- 1.63, 2.11) WOMAC PAIN  Intention to Treat (ITT) Per protocol analysis    - 0.15 (- 0.57,0.28)  - 0.30   (- 0.79,0.19)   - 0.33 (- 0.78, 0.13) - 0.47 (- 1.05, 0.10) WOMAC STIFFNESS  Intention to Treat (ITT) Per protocol analysis   - 0.05 (-0.28,0.17) - 0.12 (- 0.36,0.11)   - 0.17 (- 0.43, 0.09) - 0.13 (- 0.40, 0.14) WOMAC FUNCTION Intention to Treat (ITT) Per protocol analysis    - 1.22 (- 2.59, 0.16) - 0.80 (- 2.24, 0.63)   - 1.17 (- 2.84, 0.50) - 0.95 (- 2.63, 0.74) HADS ANXIETY  Intention to Treat (ITT) Per protocol analysis   - 0.36 (- 0.76,0.05)  - 0.68 (- 1.15,- 0.20) *   - 0.62 (-1.08,- 0.16) * - 0.72 (-1.24,- 0.21) * HADS DEPRESSION  Intention to Treat (ITT) Per protocol analysis   - 0.40 (- 0.76,- 0.03) * - 0.57 (- 0.96,- 0.18) *   - 0.41 (- 0.82, 0.01) - 0.33 (- 0.76, 0.10) ASE - PAIN  Intention to Treat (ITT) Per protocol analysis   1.63 (0.83, 2.43) * 2.55 (1.56, 3.56) *     0.98 (0.07, 1.89) * 1.43 (0.37, 2.48) * ASE - OTHER  Intention to Treat (ITT) Per protocol analysis   1.83 (0.74, 2.92) * 2.81 (1.74, 3.87) *     1.58 (0.25, 2.90) * 1.54 (0.48, 2.60) *
Outcome plots   - positive difference in means favours treatment SF 36 Mental Health SF 36 Physical Health
Outcome plots continued ASE Pain ASE Other
Outcome plots   - negative difference in means favours treatment HADS Anxiety HADS Depression
Outcome plots continued WOMAC Pain WOMAC Stiffness WOMAC Physical Functioning
12 Month Results - Summary ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Economic Evaluation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary / Discussion (1) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary / Discussion (2) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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DASH - does arthritis self-management help?

  • 1. Does Arthritis Self-management Help? A Randomised Controlled Trial of an Arthritis Self-Management Programme in Primary Care
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  • 19. Results – baseline characteristics   Intervention   n=406 Control   n=406 Age (yrs) Mean (S.D.)   68.4 (8.2 ) 68.7 (8.6) Gender Female   255 (62.8%) 255 (62.8%) Owner Occupier 323 (82.6%) 302 (78.6%) Ethnicity White   388 (99.5%) 382 (99.2%) Age left school < 16 years 249 (63.8%) 259 (67.6%) Higher education   107 (27.6%) 102 (26.7%)
  • 20.
  • 21. OUTCOMES Adjusted difference in means & (95% C.I.) at 4 months Adjusted difference in means & (95% C.I.) at 12 months SF 36 MENTAL HEALTH Intention to Treat (ITT) Per protocol analysis   0.11 (-1.18,1.40) 0.82 (-0.94,2.57)   1.35 (-0.03, 2.74) 1.56 (- 0.28, 3.39) SF 36 PHYSICAL HEALTH Intention to Treat (ITT) Per protocol analysis   0.22 (-1.5, 1.94) - 0.37 (-2.02,1.28)   0.33 (- 1.31, 1.98) 0.24 (- 1.63, 2.11) WOMAC PAIN Intention to Treat (ITT) Per protocol analysis   - 0.15 (- 0.57,0.28) - 0.30 (- 0.79,0.19)   - 0.33 (- 0.78, 0.13) - 0.47 (- 1.05, 0.10) WOMAC STIFFNESS Intention to Treat (ITT) Per protocol analysis   - 0.05 (-0.28,0.17) - 0.12 (- 0.36,0.11)   - 0.17 (- 0.43, 0.09) - 0.13 (- 0.40, 0.14) WOMAC FUNCTION Intention to Treat (ITT) Per protocol analysis   - 1.22 (- 2.59, 0.16) - 0.80 (- 2.24, 0.63)   - 1.17 (- 2.84, 0.50) - 0.95 (- 2.63, 0.74) HADS ANXIETY Intention to Treat (ITT) Per protocol analysis   - 0.36 (- 0.76,0.05) - 0.68 (- 1.15,- 0.20) *   - 0.62 (-1.08,- 0.16) * - 0.72 (-1.24,- 0.21) * HADS DEPRESSION Intention to Treat (ITT) Per protocol analysis   - 0.40 (- 0.76,- 0.03) * - 0.57 (- 0.96,- 0.18) *   - 0.41 (- 0.82, 0.01) - 0.33 (- 0.76, 0.10) ASE - PAIN Intention to Treat (ITT) Per protocol analysis   1.63 (0.83, 2.43) * 2.55 (1.56, 3.56) *   0.98 (0.07, 1.89) * 1.43 (0.37, 2.48) * ASE - OTHER Intention to Treat (ITT) Per protocol analysis   1.83 (0.74, 2.92) * 2.81 (1.74, 3.87) *   1.58 (0.25, 2.90) * 1.54 (0.48, 2.60) *
  • 22. Outcome plots - positive difference in means favours treatment SF 36 Mental Health SF 36 Physical Health
  • 23. Outcome plots continued ASE Pain ASE Other
  • 24. Outcome plots - negative difference in means favours treatment HADS Anxiety HADS Depression
  • 25. Outcome plots continued WOMAC Pain WOMAC Stiffness WOMAC Physical Functioning
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Editor's Notes

  1. Thanks for invite Introduce the recently funded DASH trial RCT of ASMP in primary care