PURPOSE: This study examined the effectiveness of an online self-management (SM) program in persons with rheumatoid arthritis (RA). METHODS: A nationwide sample (n=89) was recruited online and randomized to an Online Self-Management (OSM) group (n=43) or a Standard Care Control (CN) group (n=46). Mean age and educational levels of the sample were 50.1 (SD=11.3) and 15.6 (SD= 2.7) years, respectively; median disease duration was 4.0 years. Participants were primarily women (92%), who were married (66%), employed full-time (58%), with annual family incomes over $75,000 (36%). Uncontrolled comorbidities and psychiatric conditions were ruled out prior to randomization using a telephone screening, including the Primary Care Evaluation for Mental Disorders (PRIME-MD). Participants’ rheumatologists verified RA diagnoses. Both groups received routine rheumatologic care. The OSM group received an individualized 10-week SM intervention found to offer significant benefits in a clinic-based RA sample. This empirically-validated SM intervention was transformed online to simulate the clinic-based approach. Participants were required to read online lessons and participate in follow-up telephone counseling with an arthritis health professional. Topics included stress management, emotional responses, pain-management techniques, family adjustment and social support, adaptation to change, and general coping strategies. The OSM group was encouraged to obtain peer support by accessing an online community with discussion board, chat, and messaging. Measures of functional status, self-efficacy (SE), quality of life (QOL), social support, and pain were collected online at pre-treatment and post-treatment (3-months). RESULTS: At pre-treatment there were no group differences. Data were analyzed using one-way ANCOVAs, covarying on pre-treatment scores. Significant group effects were found on the Quality of Life Scale (p
= .009). Following Bonferoni correction, significant group effects were also found on the Arthritis Self-efficacy Scale subscales of pain (p
<0.001), function (p
<0.001) and other symptoms (p
<0.001). At post-treatment, the OSM group reported higher scores on SE and QOL than the CN group. There were no significant group effects on measures of functional status, social support, or pain. CONCLUSIONS: This study indicated that a cognitive-behavioral online self-management program offers short-term benefits on self-efficacy and overall quality of life associated with RA. The online SM approach reached broader audiences with RA and may offer benefits similar to face-to-face interventions. The Internet could be a cost-effective alternative to extend the availability of SM programs, thereby making an important contribution to community and multidisciplinary rheumatology programs.
K.L. Smarr, Support provided by the Department of Education, National Institute on Disability and Rehabilitation Research, 2; C. Siva, None; R.A. Johnson, None; K. Donovan Hanson, None; D.R. Musser, Eyebits Studios, 4; J.E. Hewett, None; B. Ge, None; J.C. Parker, None.