Mar 20, 2018

Internet Based Arthritis Self-Management Programs are Effective in Improving Health Status over the Long-Term

Posted By: Richard Iorio, MD

Arthritis is the most common cause of disability in the United State, and is a major reason for seeking medical care, and one of the most prevalent chronic conditions. In the past, evidence has been presented for the effectiveness of self-management in the treatment of arthritis-related pain and disability. The American College of Rheumatology has called for self-management education in its standard of care for osteoarthritis (OA). In addition, as part of its 2010 Goals for the Nation, the Centers for Disease Control and Prevention called for an increase in the percentage of people participating in arthritis self-management education.

The majority of previous studies have demonstrated positive changes in health status, and sometimes reduction in health care utilization, from randomized trials at short-term follow-up using analog intervention techniques. Current studies have looked at one year follow-up with continued findings of positive results for health status improvement utilizing digital tools. Internet based arthritis self-management education improves the lives of people with arthritis. The Internet is a time-efficient and convenient method to deliver health interventions with broad reach. Educational material is often accessed online by persons with chronic pain.

Remotely delivered physiotherapy and exercise can benefit persons with knee pain and osteoarthritis and those who have undergone knee joint replacement. An Internet- based interactive program designed to translate key therapeutic elements of clinician-delivered face-to-face coaching, showed improved outcomes in persons with hip or knee osteoarthritis. An online intervention combining these treatments aligns with a biopsychosocial approach to chronic disease management.

These programs have demonstrated significant improvements in health status as well as health-related behaviors, and have reduced health care utilization. These programs have reached a relatively large number of patients, and have been replicated in multiple studies with similar results. The interventions are based on self-efficacy theory and use the processes of skills mastery (action planning and feedback), modeling as supplied by the facilitators/coaches, reinterpretation of symptoms, and group persuasion.

In summary, an internet-based arthritis self-management program like the small-group program, appears to be effective in slowing or reducing the negative effects of arthritis over a 1-year period of time. Both programs should be considered for assisting patients with arthritis. Combining small group programs in a social dynamic with a digital self- management and an arthritis coach may be the best mechanism for improving arthritis care in the digital age. is one such program and integrates arthritis wellness, self-management, health status improvement and digital exercise programs with an optional social and coach driven improvement program.


  1. KATE R. LORIG, PHILIP L. RITTER, DIANA D. LAURENT, AND KATHRYN PLANT. The Internet-Based Arthritis Self-Management Program: A One-Year Randomized Trial for Patients With Arthritis or Fibromyalgia. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 59, No. 7, July 15, 2008, pp 1009 –1017. DOI 10.1002/art.23817
  2. Kim L. Bennell, BAppSci(Physio), PhD; Rachel Nelligan, BPhysio; Fiona Dobson, BAppSci(Physio), PhD; Christine Rini, PhD; Francis Keefe, BA, MS, PhD; Jessica Kasza, BSc(Hons), PhD; Simon French, BAppSc(Chiro), MPH, PhD; Christina Bryant, MA(Clin Psych), PhD; Andrew Dalwood, BAppSci(Physio), GradDipManipTherapy; J. Haxby Abbott, PhD, DPT; and Rana S. Hinman, BPhysio(Hons), PhD.Effectiveness of an Internet-Delivered Exercise and Pain-Coping Skills Training Intervention for Persons With Chronic Knee Pain: A Randomized Trial. Annals of Internal Medicine, doi:10.7326/M16-1714, 2017.
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