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Self-management interventions in the digital age: New approaches to support people with rheumatologic conditions

https://doi.org/10.1016/j.berh.2012.05.005Get rights and content

Self-management interventions are considered a key component of rheumatologic care. Access to these programmes, however, is an issue for some patients, especially those working full time or living in rural and remote communities. Recently, there has been an increase in the use of digital media technologies to deliver self-management interventions. Digital media (e.g., websites, mobile applications, social networking tools, online games and animation) provide tremendous flexibility for delivering health information and resources at a time and place that is chosen by the individual; hence, they are consistent with the patient-centred approach. This review discusses: (1) innovations in self-management interventions for patients with arthritis and (2) research in the use of digital media for delivering self-management interventions.

Section snippets

The concept of self-management

The concept of self-management is not new (Fig. 1). A recent paper by Kendall et al. [12] suggested that examples of self-management activities have existed throughout history, with the earliest activities rooted in a political context. In the early 1500s, self-organising advocacy groups were present to defend the rights of the marginalised population against the ruling elite and the government. The application of self-management for maintaining health and well-being could be dated back to 1747

Self-management education: do they meet patients' needs?

Recent literature suggests that self-management education can empower patients to become effective health-care consumers [25], [26], in addition to improving clinical outcomes. Lorig and Holman [15] distinguished patient education from self-management education. The latter employs a standardised approach to facilitate development of skills in problem solving, decision making, finding resources, forming partnerships with health-care providers and taking action. This is different from traditional

Digital media offer new ways for supporting self-management

Current evidence supports the use of digital media for improving the dissemination of health-related information and resources to support self-management [35], [36], [37], [38]. Using display platforms that vary from large screen displays to small mobile devices, applications that comprise multi-media elements can be used to deliver tailored information [39]. Various artistic forms, such as drama, music, dance and photography, may also be presented through the Internet and mobile applications

Online self-management interventions for patients with arthritis

For this review, we searched Medline from 1990 to March 2012 using the key terms ‘arthritis’ and ‘self-management’. Eligible articles were those that described or evaluated self-management interventions for patients with arthritis delivered via the Internet or mobile devices. A total of 257 articles were identified; of those, eight articles [24], [51], [52], [53], [54], [55], [56], [57] from six studies met the inclusion criteria (Table 1).

In 2001, the UK Arthritis Research Campaign developed

Online self-management interventions for patients with chronic disease

In addition to the eight studies, we identified a Cochrane review (updated in 2009) that examined the effectiveness of interactive health communication applications for people with chronic disease [69]. Interactive health communication applications are computer-based information programmes that aim to provide health information plus social support, decision support and/or behaviour change support. Users of these applications may also interact with clinical experts and other users. Twenty-four

Considerations for using online self-management interventions

The world is ready for digital media programmes to support self-management. Simple interventions, such as the use of text messaging in mobile devices, have successfully improved the adherence to medication in adults with HIV infection living in developing countries [70]. Other countries, such as Canada, are ideal for the use of computerised and mobile devices to deliver health-related interventions because of the geographically scattered population (nearly 20% living in rural and remote areas

Conclusion

In the past 30 years, we have witnessed the accumulation of evidence supporting the use of self-management programmes in patients with arthritis. In fact, these programmes are now considered a key component of quality care. To increase access to self-management interventions among those who have difficulties participating in face-to-face programmes, there has been an increasing use of digital media as a delivery method. Research in this area is still at its infancy; however, the early results

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