A review of the efficacy of the self-management model on health outcomes in community-residing older adults with arthritis

Background: Chronic disease and disability have a significant impact on individuals, families, and society, resulting in limitations in personal care, premature loss of wages, higher mortality rates, and overall poor quality of life. Arthritis is a painful disease that limits physical activity, social functioning, and mental health and is hallmarked by an increasing prevalence in community-dwelling older adults. Self-management strategies reduce pain and disability while improving self-efficacy and quality of life. Aims: The purpose of this review is to evaluate the efficacy of the self-management program in adults with arthritis on the outcome of functional disability. Methods: Literature review. Search strategy included MEDLINE, CINAHL, and the Cochrane Library from 1985 to 2008 for studies using self-management interventions. Results: Across studies of chronic disease, effect sizes were moderate for most variables. Subgroup ana- lyses for arthritis only demonstrated a greater magnitude of effect in variables related to functional health. Conclusions: While this review suggests small efficacy in the self-management program, with improvement in certain cognitive-behavioral markers for self-management, the functional gains that can be achieved in a growing older adult population translate into a larger effect overall.