Related research

Eight-year clinical trial into Challenging Arthritis, published 2008

Full title: An eight-year follow-up of arthritis self-management programme participants by J Barlow et al, published in Rheumatology, November 2008

Challenging Arthritis was shown to help people in the short and longer-term.

• By improving participants’ self-efficacy (confidence in managing their condition).
• By the continued use of some self-management techniques – such as cognitive symptom management, communication with health professionals and exercise. 
• by improving participants’ psychological well-being  – which helps participants to better manage their condition.

The analysis looked at assessments completed by 125 people with arthritis who had taken part in a Challenging Arthritis course. They filled out assessments at the beginning of the course, at four months after the course, and at eight years after the course – and ten people were interviewed.

Here are a just a few of the positive results from the trial. Eight years after the course, ratings showed:

• Confidence in managing pain had increased on average from a score of 23.6 before embarking on the course, to 26.7 (using a scale measuring 5-35, which was developed at the Stanford Patient Education Centre).
• The use of cognitive symptom management increased on average from a score of 7.1 before embarking on the course, to 9.3 (using a scale measuring 0-25, which was developed at the Stanford Patient Education Centre).
• Feelings of depression had decreased on average from a score of 7.1 before the course, to 6.0 (Using the Hospital Anxiety and Depression Scale, which measures from 0-21).

Clinical trial into Challenging Arthritis, published 2006

Full title: Self-management of arthritis in primary care: randomised controlled trial by Marta Buszewicz et al, published in BMJ on 13 October 2006

The course was shown to:

• reduce anxiety, which can impact on an individual's life with arthritis 
• improve participants’ perception of their ability to manage their symptoms

The study involved 812 people (men and women) over 50 years of age with osteoarthritis of hips or knees or both, all had taken part in the Challenging Arthritis course. They responded to questionnaires (SF-36 health survey) sent at four and 12 months after participating in the course. A control group received just an education booklet. Sample size was calculated on the basis of the primary outcome measure.

A sample of the significant results is included below.

• The anxiety subscore on the Hospital Anxiety and Depression Scale was significantly reduced at 12 months (adjusted difference in means -0.62, 95% confidence interval -1.08 to -0.16).
• A significant difference between groups for the pain subscore of the arthritis self efficacy (ASE) scale was found after four and 12 months (1.63, 0.83 to 2.43; 0.98, 0.07 to 1.89).
  

Clinical trial into Challenging Arthritis, published 2000

Full title: A randomised controlled study of the arthritis self-management programme in the UK by Julie H Barlow et al, published in Health Education Research, 2000

The course was shown to:

• improve participants’ confidence in dealing with their arthritis
• improve participants’ experiences of fatigue, anxiety and
  depressed mood
• improve participants’ use of self-management techniques

The study involved 544 people with arthritis – 311 took part in the Challenging Arthritis course and 233 were in the control group. The progress of the course participants was followed up at four months and at 12 months. The significant results included the following:

• Statistically significant mean decreases on fatigue (P < 0.0005), pain (P < 0.0005), anxiety (P < 0.0005) and depression (P < 0.0005)
• Significant mean increase on positive mood (P < 0.0005)

Challenging Pain project, 2006-2007

Full title: A pilot study to assess the effectiveness of a brief lay-led self-management education programme for patients with chronic pain, SA Andreae-Jones, J Cowlard, et al

Janet Cowlard, training services manager at Arthritis Care, worked in partnership with Dr Sarah Andreae-Jones, associate specialist in medicine, during the 18-month research project. The project involved 186 participants, who all had long-term pain and attended a Challenging Pain course in the Plymouth area.

The data is impressive. A follow-up questionnaire was sent 12 months after participants completed the Challenging Pain course, which 106 (67.1%) participants completed. Using Wilcoxon signed rank tests, the results showed that:

• pain scores were reduced 14%
• the average number of GP visits was reduced by 23%
• health distress was reduced by 31%
• self-efficacy was improved by 27%

Preparing for Work pilot, 2004-2005

The Preparing for Work pilot succeeded in helping people with arthritis in Norfolk, Suffolk and Cambridgeshire – 120 people participated in the course altogether. Of these, within 12 months:

• 26 participants entered employment, either full-time or part-time (including two people becoming self-employed)
• 29 participants entered other training (mostly IT-related)
• all participants were better informed about their condition and managing their condition in the workplace

Following the success of the pilot, Arthritis Care is rolling out the Preparing for Work course in all regions and nations, having established a reputation for quality delivery and performance.

Evaluations on Challenging Your Condition, 2007

As with all our courses, participants are asked to complete evaluation forms after finishing the Challenging Your Condition course. Those returned in 2007 showed positive results:

• 100% respondents said that the course had been useful
• Participants reported improvements in their levels of pain, tiredness and depression
• Participants said that they felt less angry, scared and frustrated

Evaluations on Positive Future Workshop, 2008

Participants completed evaluation forms for the Positive Future Workshops run in South England. Those received in 2008 showed the workshops had been hugely beneficial for both the participants and the youth volunteers:

• 100% participants and volunteers reported feeling more confident after the course
• 100% participants and volunteers reported feeling less isolated after the course
• 100% participants and volunteers reported feeling more positive about their condition after the course