AB1437-HPR Measurement issues in the evaluation of arthritis self-management interventions

Background Interventions aimed at delivering self-management support and education for people with chronic conditions have long been recognized as an important aspect of chronic disease management. However, current evidence regarding program effectiveness is mixed, in particular for people with arthritis. Objectives To provide an in-depth analysis of outcome measures used in the evaluation of chronic disease self-management programs consistent with the Stanford curricula. Methods Based on a systematic review on self-management programs, standardized effect sizes derived from reported outcome measures are categorized according to the quality of life appraisal model developed by Schwartz and Rapkin which polarizes outcomes from performance-based measures (e.g., clinical outcomes) to evaluation-based measures (e.g., emotional well-being). Results The majority of outcomes assessed in self-management trials are based on evaluative methods. Overall, effects on knowledge – the only performance-based measure observed in selected trials – are generally medium to large. In contrast, substantially more inconsistent results are found for both perception- and evaluation-based measures that mostly range between nil and small positive effects. Conclusions Effectiveness of self-management interventions, especially those aimed at people with arthritis, and resulting recommendations for health policy makers are most frequently derived from highly variable evaluation-based measures, i.e. types of outcomes that potentially carry a substantial amount of measurement error and/or bias. Therefore, decisions regarding the value and efficacy of self-management programs need to be interpreted with care. Researchers and practitioners should apply caution when selecting the range of outcome measures in self-management program evaluation. Disclosure of Interest None Declared