Het ontwikkelen en evalueren van het online zelfmanagement­programma ‘Reuma zelf te lijf ’

Summary

Participatory development and evaluation of an online self-management enhancing program for patients with Rheumatoid Arthritis
Rixt Zuidema

AIM: Firstly, to develop an online self-management programme for Dutch patients with Rheumatoid Arthritis based on the framework of Intervention Mapping. Secondly, following the Medical Research Council (MRC) Framework, this online programme was tested in a feasibility study in preparation of a larger trial.
METHOD: A multicentre exploratory RCT was conducted in 2 Dutch hospitals, including a qualitative interview study to assess reasons for usage and non-usage.
FINDINGS: Results of the exploratory RCT showed no remarkable statistically significant difference between the intervention and control group. The interview study revealed the most important results. The online programme failed to support patients in their self-management behaviour, namely: 1) most patients were not intrinsically motivated to use the programme, 2) patients had no clear or no different expectation of the programme, 3) there was a mismatch between individual support needs and needs included in the programme.
DISCUSSION and CONCLUSION: Patients should be screened on their level of motivation to change their behaviour and an action plan should be made to support them during their behavioural change. The role of healthcare professionals is essential. Healthcare professionals should support patients in their self-management behaviour, using techniques e.g. Motivational Interviewing, Shared Decision Making and goal setting.

Keywords: Self-management, E-health, rheumatoid arthritis