Self-management in osteoarthritis of hip or knee: a randomized clinical trial in a primary healthcare setting

• Published in: Journal of rheumatology Vol. 32; no. 3; pp. 543 - 549
• Main Authors: Heuts, Peter H T G, de Bie, Rob, Drietelaar, Marion, Aretz, Karin, Hopman-Rock, Marijke, Bastiaenen, Caroline H G, Metsemakers, Job F M, van Weel, Chris, van Schayck, Onno
• Format: Journal Article
• Language: English
• Published: Toronto, ON The Journal of Rheumatology 01-03-2005; Journal of Rheumatology Publishing
• Subjects: Adult; Biological and medical sciences; Disability Evaluation; Diseases of the osteoarticular system; Exercise Therapy; Female; Humans; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Osteoarthritis; Osteoarthritis, Hip - therapy; Osteoarthritis, Knee - therapy; Pain Measurement; Patient Education as Topic; Primary Health Care; Self Care; Surveys and Questionnaires; Treatment Outcome; Knee; Prognosis; Diseases of the osteoarticular system; Check; Instruction; Prevention; Pain; Limitation; Primary; Self efficacy; Clinical trial; Hip osteoarthritis; Degenerative disease; Human; General practitioner; Duration; Method; OSTEOARTHRITIS SELF-MANAGEMENT RANDOMIZED CONTROLLED TRIAL PRIMARY HEALTHCARE; Hip; Care; Clinical management; Treatment; Arthropathy; Technique; Osteoarthritis; Comparative study
• ISSN: 0315-162X; 1499-2752

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.