OBJECTIVE: Self-management courses in arthritis have been shown to improve outcomes and to decrease medical resource utilization. We studied the effectiveness of a mail-delivered arthritis self-management program with the potential for extending these effects more broadly. METHODS: Randomized controlled trial of 375 program participants and 434 controls over a 6 month period. Baseline and 6 month data were analyzed for each group and between groups by paired 2 sample t test. The intervention consists of health assessment questionnaires at 3 month intervals, with computer processed recommendation letters and reports individualized to age, diagnosis, education level, disability, pain, medication, and other patient-specific variables. RESULTS: At 6 months, outcomes of function (4.7%; 95% confidence limits 2.7 to 6.7), decreased pain (9%; 2.8 to 15.2), global vitality (7%; 2.8 to 11.2), and joint count (28%; 20 to 36) were improved in the program group compared with controls (p < 0.01). Exercise (35%; 26 to 44) and self-efficacy (14.7%; 9 to 20) were increased in the program group but not controls (p < 0.001). Doctor visits/year were decreased by 16% (3 to 29) in the program group compared with controls (p < 0.05) and days missed work or confined to home decreased by 52% (-3 to 107) in the program group compared with controls (p = 0.06). At one year, patients in the original program group continued to improve, and the control group, provided with the program in the second 6 months, showed improvement similar to the first 6 months of the original program group. CONCLUSION: A mail-delivered arthritis self-management program can positively affect patient outcomes and can decrease medical resource utilization.

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