Arthritis patient education: How economic evaluations can inform health policy

As Canadian health policy-makers struggle to contain costs while maintaining quality, patient education is promoted as making patients more effective producers of health and consumers of health care. Assessment of existing psychoeducational interventions has concentrated on knowledge enhancement, behaviour modification, and health status while economic outcomes have remained unexplored. Given that such programs are likely to be effective, but costly, economic appraisals are necessary to convince cost-conscious policy-makers. This manuscript describes a cost-effectiveness evaluation of the Arthritis Self-Management Program (ASMP) that I and my collaborators are conducting by randomizing participants to the ASMP as an adjunct to usual medical care versus usual medical care. Direct and indirect costs are evaluated through self-reporting of health services utilization and diminished productivity and effectiveness through a visual analogue scale and the SF-36. To influence health policy, the results must be disseminated to public health authorities, private insurers, and patient and health professional organizations, thereby encouraging funding, increasing awareness, and promoting participation.