Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.
BMC Musculoskelet Disord
; 13: 60, 2012 Apr 24.
Article
en En
| MEDLINE
| ID: mdl-22530979
ABSTRACT
BACKGROUND:
Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some recommended therapies are under-utilized in clinical settings, and the majority of patients with hip and knee OA are overweight and physically inactive. Consequently, interventions at the provider-level and patient-level both have potential for improving outcomes. This manuscript describes two ongoing randomized clinical trials being conducted in two different health care systems, examining patient-based and provider-based interventions for managing hip and knee OA in primary care. METHODS /DESIGN:
One study is being conducted within the Department of Veterans Affairs (VA) health care system and will compare a Combined Patient and Provider intervention relative to usual care among n = 300 patients (10 from each of 30 primary care providers). Another study is being conducted within the Duke Primary Care Research Consortium and will compare Patient Only, Provider Only, and Combined (Patient + Provider) interventions relative to usual care among n = 560 patients across 10 clinics. Participants in these studies have clinical and / or radiographic evidence of hip or knee osteoarthritis, are overweight, and do not meet current physical activity guidelines. The 12-month, telephone-based patient intervention focuses on physical activity, weight management, and cognitive behavioral pain management. The provider intervention involves provision of patient-specific recommendations for care (e.g., referral to physical therapy, knee brace, joint injection), based on evidence-based guidelines. Outcomes are collected at baseline, 6-months, and 12-months. The primary outcome is the Western Ontario and McMasters Universities Osteoarthritis Index (self-reported pain, stiffness, and function), and secondary outcomes are the Short Physical Performance Test Protocol (objective physical function) and the Patient Health Questionnaire-8 (depressive symptoms). Cost effectiveness of the interventions will also be assessed.DISCUSSION:
Results of these two studies will further our understanding of the most effective strategies for improving hip and knee OA outcomes in primary care settings. TRIAL REGISTRATION NCT01130740 (VA); NCT 01435109 (NIH).
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Atención Primaria de Salud
/
Proyectos de Investigación
/
Osteoartritis de la Cadera
/
Programas Controlados de Atención en Salud
/
Osteoartritis de la Rodilla
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Guideline
/
Qualitative_research
Aspecto:
Patient_preference
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
BMC Musculoskelet Disord
Asunto de la revista:
FISIOLOGIA
/
ORTOPEDIA
Año:
2012
Tipo del documento:
Article
País de afiliación:
Estados Unidos