Title
Self-management in osteoarthritis of hip or knee: A randomized clinical trial in a primary healthcare setting
Author
Heuts, P.H.T.G.
de Bie, R.
Drietelaar, M.
Aretz, K.
Hopman-Rock, M.
Bastiaenen, C.H.G.
Metsemakers, J.F.M.
van Weel, C.
van Schayck, O.C.P.
TNO Preventie en Gezondheid
Publication year
2005
Abstract
Objective. To assess in a primary healthcare setting the efficacy of a self-management program in middle-aged patients with osteoarthritis (OA). Methods. This was a 2-group randomized controlled trial, with 273 patients aged 40 to 60 years with OA of the hip(s) and/or knee(s). The experimental intervention was compared with care-as-usual. Treatments and followup measurements were performed in a general healthcare setting by general practitioners. Duration of followup was 21 months after start of the intervention. Instruction in self-management techniques was given by physiotherapists. The main outcome measures were pain severity in hips and knees, other significant complaints, and functional limitations. Results. To begin, 297 patients were randomized: 149 as self-management and 148 controls; before the intervention 24 withdrew for practical reasons (17 self-management, 7 controls). At 3-month followup the intervention group was significantly improved on a visual analog scale (VAS) for knee pain (score 0.67; SD 2.10) and the WOMAC (score 2.46; SD 9.49), while the control group showed stable VAS knee pain (0.01; SD 2.00) and deterioration on WOMAC (-0.53; SD 9.47). At 21-month followup the differences between the groups increased in favor of the intervention group (VAS pain knee: p values from 0.023 at 3 mo to 0.004 at 21 mo; WOMAC: p values from 0.030 to 0.022). Conclusion. The self-management program positively influenced knee pain and self-reported functional level in this sample of patients with OA. Differences between the study groups increased during followup in favor of the intervention group.
Subject
Primary healthcare
Randomized controlled trial
Self-management
clinical trial
controlled clinical trial
controlled study
disease severity
follow up
general practice
health care cost
hip osteoarthritis
knee osteoarthritis
major clinical study
management
outcomes research
pain assessment
physiotherapist
primary health care
randomization
randomized controlled trial
visual analog scale
Adult
Disability Evaluation
Exercise Therapy
Female
Humans
Male
Middle Aged
Osteoarthritis, Hip
Osteoarthritis, Knee
Pain Measurement
Patient Education
Primary Health Care
Questionnaires
Self Care
Treatment Outcome
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http://resolver.tudelft.nl/uuid:e104e464-6082-4b6a-83e7-fd54f29c62d5
TNO identifier
238381
ISSN
0315-162X
Source
Journal of Rheumatology, 32 (3), 543-549
Document type
article