Dataset Information

Digital self-management of hip and knee osteoarthritis and trajectories of work and activity impairments.

ABSTRACT:

Objective

To investigate the trajectories of work and activity impairments among people participating in a digital self-management program for osteoarthritis (OA).

Methods

We conducted an observational longitudinal study using data for baseline, 3, 6, 9 and 12 months follow ups from people participating in a digital OA treatment between June 2018 and September 2021. The Work Productivity and Activity Impairment-Osteoarthritis (WPAI-OA) questionnaire was used to measure work and activity impairments. We applied linear mixed models and group-based trajectory modelling (GBTM) to assess the trajectories of work and activity impairments and their variability. Dominance analysis was performed to explore the relative importance of baseline characteristics in predicting the trajectory subgroup membership.

Results

A total of 14,676 participants with mean (± standard deviation) age 64.0 (± 9.1) years and 75.5% females were included. The adjusted mean improvements in work impairment from baseline were 5.8% (95% CI 5.3, 6.4) to 6.1% (95% CI 5.5, 6.8). The corresponding figures for activity impairment were 9.4% (95% CI 9.0, 9.7) to 11.3% (95% CI 10.8, 11.8). GBTM identified five (low baseline-declining, moderate baseline-declining, high baseline-declining, very high baseline-substantially declining, and very high baseline-persistent) and three (low baseline-declining, mild baseline-declining, high baseline-declining) subgroups with distinct trajectories of activity and work impairments. Dominance analysis showed that baseline pain was the most important predictor of membership in trajectory subgroups.

Conclusion

While participation in a digital self-management program for OA was, on average, associated with improvements in work and activity impairments, there were substantial variations among the participants. Baseline pain may provide useful insights to predict trajectories of work and activity impairments.

SUBMITTER: Kiadaliri A

PROVIDER: S-EPMC10024026 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

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Publications

Digital self-management of hip and knee osteoarthritis and trajectories of work and activity impairments.

Kiadaliri Ali A Lohmander L Stefan LS Ignjatovic Majda Misini MM Nero Håkan H Dahlberg Leif E LE

BMC musculoskeletal disorders 20230318 1

<h4>Objective</h4>To investigate the trajectories of work and activity impairments among people participating in a digital self-management program for osteoarthritis (OA).<h4>Methods</h4>We conducted an observational longitudinal study using data for baseline, 3, 6, 9 and 12 months follow ups from people participating in a digital OA treatment between June 2018 and September 2021. The Work Productivity and Activity Impairment-Osteoarthritis (WPAI-OA) questionnaire was used to measure work and ac ...[more]

PMID: 36934223

Similar Datasets

Project description:ObjectiveTo determine the feasibility of conducting a randomised controlled trial (RCT) of a peer mentorship intervention to improve self-management of osteoarthritis (OA).DesignSix-month parallel group non-blinded randomised feasibility trial.SettingOne secondary care and one primary care UK National Health Service Trust.ParticipantsFifty adults aged ≥55 years old with hip and/or knee OA.InterventionsParticipants were allocated 1:1 to the intervention or control group using an online randomisation service. Intervention group participants received usual care (information resources) and up to eight community-based self-management support sessions delivered by a peer mentor (trained volunteer with hip and/or knee OA). Control group participants received usual care only.Outcome measuresKey feasibility outcomes were participant and peer mentor recruitment and attrition, intervention completion and the sample size required for a definitive RCT. Based on these feasibility outcomes, four success criteria for proceeding to a definitive RCT were prespecified. Patient-reported outcomes were collected via questionnaires at baseline, 8 weeks and 6 months.ResultsNinety-six individuals were screened, 65 were eligible and 50 were randomised (25 per group). Of the 24 participants who commenced the intervention, 20 completed it. Four participants did not complete the 6-month questionnaire. Twenty-one individuals were eligible for the peer mentor role, 15 were trained and 5 withdrew prior to being matched with a participant. No intervention-related harms occurred. Allowing for 20% attrition, the sample size required for a definitive RCT was calculated as 170 participants. The intervention group showed improvements in self-management compared with the control group.ConclusionsThe feasibility outcomes achieved the prespecified criteria for proceeding to an RCT. The exploratory analyses suggest peer mentorship may improve OA self-management. An RCT of the OA peer mentorship intervention is therefore warranted with minor modifications to the intervention and trial procedures.Trial registration numberISRCTN:50675542.

Project description:IntroductionOsteoarthritis (OA) has traditionally been considered a condition of older age. However, younger people are also affected by hip and knee OA, often as a result of sporting and work-related injuries. As OA studies have generally focused on older individuals, little is known about the experience of younger adults with hip or knee OA who can face a distinct set of pressures including work responsibilities and parenting roles. This study aims to investigate well-being and work participation among younger people with hip or knee OA, as well as preferences for OA education and support.Methods and analysis200 people aged 20-55 years with a diagnosis of hip and/or knee OA will be recruited for this cross-sectional study. Participants will be recruited from three major public hospitals in the state of Victoria, Australia following screening of orthopaedic outpatient clinic lists and referrals, and through community-based advertisements. A study questionnaire will be mailed to all participants and written informed consent obtained. Validated measures of Health-Related Quality of Life (HRQoL), health status, psychological distress and work limitations will be used. Information on health services use will be collected, in addition to information on the perceived utility and accessibility of a range of existing and proposed education and peer support models. HRQoL data will be compared with Australian population norms using independent t tests, and associations between HRQoL, health status, psychological distress, work limitations and demographic factors will be evaluated using univariate and multivariate analyses. Data on the perceived utility and accessibility of education and peer support models will be analysed descriptively.Ethics and disseminationEthics approval for the study has been obtained. The study findings will be submitted to peer-reviewed journals and arthritis consumer organisations for broader dissemination, and presented at national and international scientific meetings.

Project description:ImportanceDigital care platforms have been introduced, but there is limited evidence for their efficacy compared with traditional face-to-face treatment modalities.ObjectiveTo compare mean pain reduction among individuals with osteoarthritis (OA) of the knee or hip who underwent face-to-face vs digital first-line intervention.Design, setting, and participantsThis registry-based cohort study included all persons with knee or hip osteoarthritis who participated in structured first-line treatment for osteoarthritis in a primary care setting in Sweden. Inclusion criteria were as follows: the treatment was delivered face-to-face or digitally between April 1, 2018, and December 31, 2019; patients provided 3-month follow-up data for pain; and patients had program adherence of at least 80%. Data analysis was conducted in March 2021.ExposuresParticipants completed a 3-month intervention, including education and exercise for hip or knee osteoarthritis, with program adherence of 80% or higher, delivered face-to-face or by a digital application.Main outcomes and measuresDifference in change in joint pain (11-point numeric rating scale, with 0 indicating no pain and 10, the worst possible pain) between baseline and 3-month follow-up between the 2 intervention modalities. A minimal clinically important difference in pain change between groups was predefined as 1 point. Secondary outcomes were walking difficulties, health-related quality of life, willingness to undergo joint surgery, and fear avoidance behavior.ResultsA total of 6946 participants (mean [SD] age, 67 [9] years; 4952 [71%] women; 4424 [64%] knee OA; 2504 [36%] hip OA) were included, with 4237 (61%) receiving face-to-face treatment and 2709 (39%) receiving digital treatment. Both the face-to-face (mean change, -1.10 [95% CI -1.17 to -1.02] points) and digital interventions (mean change, -1.87 [95% CI, -1.94 to -1.79] points) resulted in a clinically important pain reduction at 3 months. Participants in the digitally delivered intervention experienced a larger estimated improvement at 3 months (adjusted mean difference, -0.93 [95% CI, -1.04 to -0.81] points). Results of secondary outcomes were broadly consistent with main outcome.Conclusions and relevanceThis Swedish national registry-based cohort study showed that people with knee or hip OA participating in first-line intervention experienced clinically relevant improvements in pain, whether delivered face-to-face or digitally. The increased benefit of digital delivery compared with face-to-face delivery was of uncertain clinical importance.

Dataset Information

Digital self-management of hip and knee osteoarthritis and trajectories of work and activity impairments.

Objective

Methods

Results

Conclusion

Publications

Digital self-management of hip and knee osteoarthritis and trajectories of work and activity impairments.

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