Non Surgical Priority 5 from the Early Hip and Knee Osteoarthritis PSP

UNCERTAINTY: What options are available for OA self management and how effective are they? (JLA PSP Non Surgical Priority 5
Overall ranking amongst non surgical questions 5
JLA question ID 0041/15
Extra explanatory note Definition of self management needed, a course, guidance? It's about ownership of self management once established with effective options presented. Role of enthusiasm of practitioner as well.
Intervention; self efficacy, empowerment and agency all concepts that apply here.
Outcomes; reduction in hospital or primary care visits, measures of self empowerment, improved quality of life, stable or reduced pain and stable or improved function
Evidence

Self-management education programmes for osteoarthritis DOI: 10.1002/14651858.CD008963.pub2 http://www.ncbi.nlm.nih.gov/pubmed/24425500

Low to moderate quality evidence indicates that self-management education programmes result in no or small benefits in people with osteoarthritis but are unlikely to cause harm. Compared with attention control, these programmes probably do not improve self-management skills, pain, osteoarthritis symptoms, function or quality of life, and have unknown effects on positive and active engagement in life. Compared with usual care, they may slightly improve self-management skills, pain, function and symptoms, although these benefits are of unlikely clinical importance.

Further studies investigating the effects of self-management education programmes, as delivered in the trials in this review, are unlikely to change our conclusions substantially, as confounding from biases across studies would have likely favoured self-management. However, trials assessing other models of self-management education programme delivery may be warranted. These should adequately describe the intervention they deliver and consider the expanded PROGRESS-Plus framework and health literacy, to explore issues of health equity for recipients.
Health Research Classification System category Musculoskeletal
Extra information provided by this PSP
Original uncertainty examples What can I do to help myself?  ~  How can I self-manage my osteoarthritis more effectively?  ~  Dr just gives painkillers but how do I self manage flare ups?  ~  what are the most important active ingredients that help prevent/delay/manage osteoarthritis e.g. stretching, strengthening, mobility, specific nutrients etc.
Submitted by 5 patient/carers, 5 clinicians and 2 carer/clinicians
PSP information
PSP unique ID 0041
PSP name Early Hip and Knee Osteoarthritis
Total number of uncertainties identified by this PSP. 52  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 26 February 2016