The Better Management of Patients with Osteoarthritis Program: Outcomes after evidence-based education and exercise delivered nationwide in Sweden


Autoři: Thérése Jönsson aff001;  Frida Eek aff002;  Andrea Dell’Isola aff001;  Leif E. Dahlberg aff001;  Eva Ekvall Hansson aff002
Působiště autorů: Department of Clinical Sciences Lund, Ortopedics, Lund University, Lund, Sweden aff001;  Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden aff002
Vyšlo v časopise: PLoS ONE 14(9)
Kategorie: Research Article
doi: 10.1371/journal.pone.0222657

Souhrn

We evaluated a structured education- and exercise-based self-management program for patients with knee or hip osteoarthritis (OA), using a registry-based study of data from 44,634 patients taken from the Swedish “Better Management of Patients with Osteoarthritis” registry. Outcome measures included a numeric rating scale (NRS), EuroQol five dimension scale (EQ-5D), Arthritis self-efficacy scale (ASES-pain and ASES-other symptoms), pain frequency, any use of OA medication, desire for surgery, fear–avoidance behavior, physical activity, and sick leave were reported at baseline, 3 and 12 month. Changes in scale variables were analyzed using general linear models for repeated measures and changes in binary variables by McNamara’s test. All analyses were stratified by joint. At the 3-month follow-up, patients with knee (n = 30686) and hip (n = 13948) OA reported significant improvements in the NRS-pain, the EQ-5D index, the ASES-other symptoms, and ASES-pain scores with standardized effect size (ES) ranges for patients with knee OA of 0.25–0.57 and hip OA of 0.15–0.39. Significantly fewer patients reported pain more than once weekly, took OA medication, desired surgery, showed fear–avoidance behavior, and were physically inactive. At the 12-month follow-up, patients with knee (n = 21647) and hip (n = 8898) OA reported significant improvements in NRS-pain, EQ-5D index, and a decrease in ASES-other symptoms and ASES-pain scores with an ES for patients with knee OA of –0.04 to 0.43 and hip OA of –0.18 to 0.22. Significantly fewer patients reported daily pain, desired surgery (for hip OA), reported fear–avoidance behavior, and reported sick leave. Following these interventions, patients with knee and hip OA experienced significant reductions in symptoms and decreased willingness to undergo surgery, while using less OA medication and taking less sick leave. The results indicate that offering this program as the first-line treatment for OA patients may reduce the burden of this disease.

Klíčová slova:

Medicine and health sciences – Rheumatology – Arthritis – Osteoarthritis – Pelvis – Hip – Health care – Patients – Surgical and invasive medical procedures – Public and occupational health – Physical activity – Biology and life sciences – Anatomy – Musculoskeletal system – Body limbs – Legs – Knees – Skeletal joints – Knee joints – People and places – Geographical locations – Europe – European Union – Sweden


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2019 Číslo 9

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