Budget impact of the Walk With Ease program for knee osteoarthritis.

Objective: Walk With Ease (WWE) is an effective low-cost walking program. We estimated the budget impact of implementing WWE in persons with knee osteoarthritis (OA) as a measure of affordability that can inform payers' funding decisions. Methods: We estimated changes in two-year healthcare costs with and without WWE. We used the Osteoarthritis Policy (OAPol) Model to estimate per-person medical expenditures. We estimated total and per-member-per-month (PMPM) costs of funding WWE for a hypothetical insurance plan with 75,000 members under two conditions: 1) all individuals aged 45+ with knee OA eligible for WWE, and 2) inactive and insufficiently active individuals aged 45+ with knee OA eligible. In sensitivity analyses, we varied WWE cost and efficacy and considered productivity costs. Results: With eligibility unrestricted by activity level, implementing WWE results in an additional $1,002,408 to the insurance plan over two years ($0.56 PMPM). With eligibility restricted to inactive and insufficiently active individuals, funding WWE results in an additional $571,931 over two years ($0.32 PMPM). In sensitivity analyses, when per-person costs of $10 to $1000 were added with 10-50% decreases in failure rate (enhanced sustainability of WWE benefits), two-year budget impact varied from $242,684 to $6,985,674 with unrestricted eligibility and from -$43,194 (cost-saving) to $4,484,122 with restricted eligibility. Conclusion: Along with the cost-effectiveness of WWE at widely accepted willingness-to-pay thresholds, these results can inform payers in deciding to fund WWE. In the absence of accepted thresholds to define affordability, these results can assist in comparing the affordability of WWE with other behavioral interventions.

Walk with ease for knee osteoarthritis: A cost-effectiveness analysis.

Objective: The Walk With Ease (WWE) program was developed by the Arthritis Foundation to help people with arthritis learn to exercise safely and improve arthritis symptoms. We sought to establish the value of the WWE program. Methods: We used the Osteoarthritis Policy (OAPol) Model, a widely published and validated computer simulation of knee osteoarthritis (OA), to assess the cost-effectiveness of WWE in knee OA. We derived model inputs using data from a workplace wellness initiative in Montana that offered WWE to state employees. Our primary outcomes were quality-adjusted life years (QALYs) and costs over a 2-year period, which we used to calculate the incremental cost-effectiveness ratio (ICER). The base case analysis was restricted to subjects who were inactive or insufficiently active (<180 â€‹min/week of PA) at baseline. We performed scenario and probabilistic sensitivity analyses to determine the impact of uncertainty in model parameters on our results. Results: In the base case analysis, adding WWE to usual care resulted in an ICER of $47,900/QALY. When the program was offered without preselection by baseline activity level, the ICER for WWE â€‹+ â€‹usual care was estimated at $83,400/QALY. Results of the probabilistic sensitivity analysis indicated that WWE offered to inactive or insufficiently active individuals has a 52% chance of having an ICER <$50,000/QALY. Conclusion: The WWE program offers good value for inactive/insufficiently active individuals. Payers may consider including such a program to increase physical activity in individuals with knee OA.

Reach and Impact of In-Person and Remote Delivery Formats of Walk with Ease.

This descriptive study retrospectively evaluates the reach and impact of cohorts enrolled in Group (in-person, 2017-2020) and Self-Directed (remote, 2019-2020) delivery formats of the evidenced-based health promotion program, Walk with Ease, implemented statewide in North Carolina. An existing dataset consisting of pre- and post-surveys were analyzed for 1,890 participants; 454 (24%) from the Group format and 1,436 (76%) from Self-Directed. Self-Directed participants were younger, had more years of education, represented more Black/African American and multi-racial participants, and participated in more locations than Group, though a higher percentage of Group participants were from rural counties. Self-Directed participants were less likely to report having arthritis, cancer, chronic pain, diabetes, heart disease, high cholesterol, hypertension, kidney disease, stroke, or osteoporosis, though more likely to report being obese or having anxiety or depression. All participants walked more and expressed higher confidence in managing joint pain following the program. These results promote opportunities for enhancing engagement in Walk with Ease with diverse populations.

Responding to stakeholder needs to engage rehabilitation professionals in the delivery of evidence-based health programming for adults with osteoarthritis.

Although there are many evidence-based programs that promote healthy lifestyles and symptom modification for people with osteoarthritis, their delivery in rehabilitation clinical settings in the United States is limited. These programs can be a primary component of treatment or a discharge option to facilitate long-term mobility and pain management. The purpose of this perspective article is to describe a delivery model that brings one arthritis-appropriate, evidence-based intervention, the Arthritis Foundation's Walk With Ease program, to older adults seeking physical therapy related to their osteoarthritis. We embedded program delivery into a Doctor of Physical Therapy curriculum using a student health coaching approach and partnering with physical therapy clinics and other community agencies for participant referrals. This model of delivery is cost-effective, sustainable, and provides outcomes that meet goals of the national agenda for osteoarthritis. The model provides benefits for students in health professions education programs, community organizations and rehabilitation clinics, and adults living with osteoarthritis.

Public Health Interventions for Osteoarthritis - updates on the Osteoarthritis Action Alliance's efforts to address the 2010 OA Public Health Agenda Recommendations.

Osteoarthritis (OA) is a painful joint disease affecting more than 32.5 million adults in the US and over 350 million adults worldwide. The prevalence is expected to rise continually over the next several decades with significant impacts to societal health and economic costs as well as individuals' daily activities and quality of life. In 2008, the Centers for Disease Control and Prevention (CDC) and the Arthritis Foundation (AF) led a collaborative effort to address approaches to reduce the burden of OA via public health interventions, policies (systems and environmental), and communication strategies. This collaboration resulted in the National Public Health Agenda for OA (OA Agenda), which was vetted by more than 75 stakeholder organisations and released in 2010. The OA Agenda listed ten recommendations focused on public health interventions for OA including weight management, physical activity, self-management education, and injury prevention, and policies, systems, communication, research and evaluation. In 2011, the CDC and AF mobilised the OA Action Alliance (OAAA), a national coalition of organisations concerned with mitigating the public health impact of OA, to operationalise the recommendations set forth in the OA Agenda. Since then, the OAAA has grown to include more than 110 organisations that work collectively to increase awareness about the prevention and management of OA, provide educational resources, and expand access to evidence-based programmes for target audiences including individuals with OA, community-based organisations, healthcare systems and providers, and policymakers. This review highlights the OAAA's progress to date in addressing the OA Agenda recommendations; successes and challenges in delivery of effective communication, programmes, and resources; and future implications.