Self Management Program for Elders with Osteoarthritis

Blixen, Carol

Abstract

This project will test the feasibility of a nurse-run educational telephone support program for older adults with osteoarthritis (OA). Findings from the proposed pilot study will provide essential information for submission of an RO1 proposal for a randomized clinical trial.
Specific Aims of this study are to obtain estimates of. 1) accessibility and availability of subjects; 2) refusal rates; 3) selection issues; 4) ease of administration of instruments and intervention sessions; 5) reliability of measures; 6) program costs; and 7) health care resource use costs. We will also 8) develop a database management system and 9) test the known relationships between the variables. Methodology: 1. Study Design - A 6-month prospective randomized pilot study. 2. Subject Recruitment - 32 older adults (16 intervention; 16 usual care) aged 60 and over with a documented diagnosis of OA who are followed in a hospital based arthritis clinic at the Cleveland Clinic Foundation and The Cleveland Department of Veterans' Affairs Medical Center will be sent a letter describing the study and asking for his/her participation. A week later, an interviewer will telephone each subject, and if the subject agrees to participate, a baseline interview will be conducted by telephone. 3. Educational Intervention - Weekly individualized 1-hour telephone educational support sessions that will provide information on pathology, medications, pain, depression, exercise, relaxation techniques, communicating with professionals, and steps needed to reach patient goals will be provided for one month. """"""""Reinforcement"""""""" mailings, which will review the information from the telephone sessions, will be sent at 3 and 6 months. The control group will receive usual care. 4. Outcomes Measurement - 1) accessibility and availability of subjects; 2) refusal rates; 3) selection issues; 4) ease of administration of instruments and intervention sessions; 5) and reliability of measures. In addition, telephone interviews at baseline, and at 3 and 6 months will, be conducted to obtain information on: 6) OA related self-efficacy and quality of life; 7) concerns/beliefs about OA; 8) OA management behaviors; 9) overall health status; 10) functional status; 11) satisfaction with OA care; 12) pain; 13) depression. 14) days missed from work/school; 15) OA related health care resource use and 15) program costs. Significance: OA is the most significantly disabling condition appearing in older persons. Incurable by definition, management of this chronic disease extends over time, creating continuous costs for both patient and provider. This pilot study will provide invaluable information on the feasibility of implementing a self-management intervention for elders with OA throughout a healthcare system.