Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

A critical look at the role of self-management for people with arthritis and other chronic diseases

Nature Clinical Practice Rheumatology volume 4, pages 224–225 (2008)Cite this article

Chronic disease can affect every aspect of a person's day-to-day life. Although the individual adapts to these effects over time, health-care systems could do more to provide patients with necessary skills and resources. Self-management programs have been designed to help fill this void, and are in an early stage of development. Given that encounters between health-care professionals and patients with chronic conditions are sporadic, and their overall impact on patient wellbeing is small, the potential capacity of patient self-management has been viewed as large but underdeveloped. There is a range of influencing factors, however, that might impact on the effectiveness of self-management programs for patients with long-term conditions; these influences relate to the personal and social resources patients are able to access, the response and role of clinicians, and the workings of the broader health-care system.

A distinction can be made between 'self-management' and 'self-management support'. Self-management is a normal part of daily living, and involves the actions individuals take for themselves and their families to stay healthy and to care for minor, acute and long-term conditions. Self-management support is the facility that health-care and social-care services provide to enable individuals to take better care of themselves. The onus in recent times has been on delivering training for self-management skills to individuals through a range of interventions.1

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Jordan JE and Osborne RH (2007) Chronic disease self-management education programs: challenges ahead. Med J Aust 186: 84–87

    PubMed  Google Scholar 

  2. National Primary Care Research & Development Centre (2007) The national evaluation of the pilot phase of the Expert Patients Programme: final report. Manchester, UK: NPCRDC

  3. Gately C et al. (2007) Re-thinking the relationship between long-term condition self-management education and the utilisation of health services. Soc Sci Med 65: 934–945

    Article  Google Scholar 

  4. Ingverson L et al. (2005) Factors affecting the impact of professional development programs on teachers' knowledge, practice, student outcomes and efficacy. Education Policy Analysis Archives 13 (10): 1–28

    Google Scholar 

  5. Osborne RH et al. (2007) Does self-management lead to sustainable health benefits in people with arthritis? A 2-year transition study of 452 Australians. J Rheumatol 34: 1112–1117

    PubMed  Google Scholar 

  6. Kennedy A et al. (2007) The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial. J Epidemiol Community Health 61: 254–261

    Article  Google Scholar 

  7. Chodosh J et al. (2005) Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 143: 427–438

    Article  Google Scholar 

  8. Devos-Comby L et al. (2006) Do exercise and self-management interventions benefit patients with osteoarthritis of the knee? A metaanalytic review. J Rheumatol 33: 744–756

    PubMed  Google Scholar 

  9. Osborne RH et al. (2007) The Health Education Impact Questionnaire (heiQ): an outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions. Patient Educ Couns 66: 192–201

    Article  Google Scholar 

  10. Kennedy A et al. (2005) Assessing the introduction of the expert patients programme into the NHS: a realistic evaluation of recruitment to a national lay-led self care initiative. Primary Health Care Res Dev 6: 137–148

    Article  Google Scholar 

  11. Wilkinson RG (2005) The Impact of Inequality: how to make sick societies healthier. London, UK: Routledge

    Google Scholar 

Download references

Acknowledgements

RH Osborne is funded in part by a National Health and Medical Research Council Population Health Career Development Award.

Author information

Authors and Affiliations

  1. Department of Medicine, RH Osborne is an Epidemiologist and Health Services Researcher and JE Jordan is a Research Fellow at the Centre for Rheumatic Diseases, Royal Melbourne Hospital, The University of Melbourne, Australia.,

    Richard H Osborne & Joanne E Jordan

  2. RH Osborne is also Director of the Australian Work Health Program—Arthritis, and of the Victorian Orthopaedic Waiting List Prioritisation and Management Reform program. A Rogers is Head of the Primary Care Group, School of Community-Based Medicine, University of Manchester, UK, and Director of the Self Management Programme of Research at the National Primary Care Research and Development Centre, UK.,

    Richard H Osborne & Anne Rogers

Authors
  1. Richard H Osborne
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joanne E Jordan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anne Rogers
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard H Osborne.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Supplementary information

Supplementary Table 1

Suite of self-management education interventions (DOC 48 kb)

Supplementary Box 1

Potential challenges faced by patients with chronic arthritis that may limit engagement in self-management support interventions (DOC 42 kb)

Supplementary Table 2

Needs and concerns relating to the implementation of self-management programs (DOC 46 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Osborne, R., Jordan, J. & Rogers, A. A critical look at the role of self-management for people with arthritis and other chronic diseases. Nat Rev Rheumatol 4, 224–225 (2008). https://doi.org/10.1038/ncprheum0765

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncprheum0765

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing