Self-Management Strategies*

Abstract

Self-management activities, such as participation in education programs and physical activity, are central to the nonpharmacological management outlined in American College of Rheumatology guidelines for arthritis management. Anything a person does to try to manage their arthritis could be considered self-management, but the Institute of Medicine (IOM) definition of self-management focuses on essential tasks. The IOM defines self-management as “the tasks that the individuals must undertake to live well with one or more chronic conditions” (1). While individuals with arthritis try a variety of strategies to live well with their disease, scientific evidence supports only a limited number of key self-management activities. This chapter reviews the evidence base for the three self-management strategies with the broadest applicability: participating in self-management education, maintaining regular, moderate intensity physical activity, and controlling weight. These three strategies also form the core public health messages for disability prevention promoted by the Centers for Disease Control and Prevention’s arthritis program (see Table 38-1 for a summary of these strategies). A fourth strategy, seeking early diagnosis and appropriate medical treatment if rheumatoid arthritis is suspected, is of more targeted applicability, and will not be addressed here. This chapter will conclude with recommendations for improving the effectiveness of clinician counseling through the use of a brief behavioral counseling model to assist patients in practicing self-management.

*The findings and conclusions in this book chapter are those of the author and do not necessarily represent the views of the Centers for Disease Control and Prevention.