Presentation: A Health Care Provider’s Recommendation is the Most Influential Factor in Taking an Arthritis Self-Management Course (SMC): A National Perspective from the Arthritis Conditions Health Effects Survey (ACHES) (2007)

720 A Health Care Provider’s Recommendation is the Most Influential Factor in Taking an Arthritis Self-Management Course (SMC): A National Perspective from the Arthritis Conditions Health Effects Survey (ACHES)

PURPOSE: To estimate the proportion of people with arthritis who were told by their health care provider (HCP) to take an arthritis self-management course (SMC), the proportion who had ever taken a SMC, and correlates of each.
METHODS: The study sample comprised 1,793 respondents from ACHES, a national random-digit dialed telephone survey of the civilian, non-institutionalized US population aged >=45 years with doctor diagnosed arthritis, conducted in 2005-2006. People were classified as having doctor diagnosed arthritis if they reported ‘yes’ to ‘Have you EVER been told by a doctor or other health professional that you have some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia?’ Participants were asked if their HCP had ever suggested taking a SMC to teach them how to manage problems related to arthritis or joint symptoms, and whether they had ever taken a SMC. Associations for each (being recommended to take a SMC; taking a SMC) were estimated in multivariable adjusted, backward selection stepwise logistic regression models. Covariates considered in these models included socio-demographic, physical function, attitude and confidence variables. Analyses were conducted in SAS and SUDAAN, adjusting for the complex survey design.
RESULTS: Ten percent (95% confidence interval (CI)=8-12%) of respondents had been advised by their HCP to take an arthritis SMC. The strongest and only statistically significant (α=0.05) correlate of having been told to attend a SMC was the SF-36 score; those in the lowest and mid tertiles of the physical function score were 3.6 and 2 times (odds ratio (OR)=3.6; 95% CI=2.0-6.7 and OR=2.0; 95% CI=1.1 - 3.4 respectively) more likely to have been told to take a SMC than those in the highest tertile. While 10% (95% CI=8-11%) of all respondents reported taking a SMC, only half of these respondents (48%; 95% CI=40-56%) had been advised by a HCP to take a SMC. Nevertheless, the multivariable analysis indicated that having been advised to take a SMC was the strongest correlate of taking a SMC (OR=27.6 (95% CI=10.7- 72.0). Those who believed that people could do things to make their arthritis better (OR=6.4; 95% CI=1.4-30.1), and those who agreed that it was important for someone with arthritis to take a SMC to manage their symptoms (OR=12.1; 95% CI=1.1-99.3) were also more likely to have taken a SMC.
CONCLUSIONS: Despite only 50% follow-up with a HCP’s recommendation to take a SMC, this may be by far the most influential factor in whether people with arthritis take a SMC. Results also suggest that providers may wait until people have substantial physical function limitations before recommending a SMC. Our results suggest that people with arthritis do follow HCP’s recommendations, and that HCPs would be wise to recommend SMCs to people with arthritis earlier and more frequently.

 L. Murphy, None; K. Theis, None; T. Brady, None; J. Hootman, None; C. Helmick, None; J. Bolen, None; J. Sacks, None.