Telephone-based self-management of osteoarthritis: A randomized trial.
Date
2010-11
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Abstract
Background
Osteoarthritis is a leading cause of pain and disability, and self-management behaviors for osteoarthritis are underutilized.Objective
To examine the effectiveness of a telephone-based self-management intervention for hip or knee osteoarthritis in a primary care setting.Design
Randomized clinical trial with equal assignment to osteoarthritis self-management, health education (attention control), and usual care control groups. (ClinicalTrials.gov registration number: NCT00288912)Setting
Primary care clinics in a Veterans Affairs Medical Center.Patients
515 patients with symptomatic hip or knee osteoarthritis.Intervention
The osteoarthritis self-management intervention involved educational materials and 12 monthly telephone calls to support individualized goals and action plans. The health education intervention involved nonosteoarthritis educational materials and 12 monthly telephone calls related to general health screening topics.Measurements
The primary outcome was score on the Arthritis Impact Measurement Scales-2 pain subscale (range, 0 to 10). Pain was also assessed with a 10-cm visual analog scale. Measurements were collected at baseline and 12 months.Results
461 participants (90%) completed the 12-month assessment. The mean Arthritis Impact Measurement Scales-2 pain score in the osteoarthritis self-management group was 0.4 point lower (95% CI, -0.8 to 0.1 point; P = 0.105) than in the usual care group and 0.6 point lower (CI, -1.0 to -0.2 point; P = 0.007) than in the health education group at 12 months. The mean visual analog scale pain score in the osteoarthritis self-management group was 1.1 points lower (CI, -1.6 to -0.6 point; P < 0.001) than in the usual care group and 1.0 point lower (CI, -1.5 to -0.5 point; P < 0.001) than in the health education group. Health care use did not differ across the groups.Limitation
The study was conducted at 1 Veterans Affairs Medical Center, and the sample consisted primarily of men.Conclusion
A telephone-based osteoarthritis self-management program produced moderate improvements in pain, particularly compared with a health education control group.Primary funding source
U.S. Department of Veterans Affairs Health Services Research and Development Service.Type
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Allen, Kelli D, Eugene Z Oddone, Cynthia J Coffman, Santanu K Datta, Karen A Juntilla, Jennifer H Lindquist, Tessa A Walker, Morris Weinberger, et al. (2010). Telephone-based self-management of osteoarthritis: A randomized trial. Annals of internal medicine, 153(9). pp. 570–579. 10.7326/0003-4819-153-9-201011020-00006 Retrieved from https://hdl.handle.net/10161/30104.
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Scholars@Duke
Kelli Dominick Allen
- Improving care and outcomes for individuals with osteoarthritis and other musculoskeletal conditions with an emphasis on non-pharmacological therapies including physical activity, weight management, rehabilitation services, and pain coping
* Understanding rand reducing disparities in musculoskeletal conditions
* Musculoskeletal conditions in U.S. military Veterans
* Pragmatic clinical trials
* Adaptive interventions
Eugene Zaverio Oddone
I am a health services researcher whose primary research interests are: 1) evaluating the effectiveness of primary care with an emphasis on chronic disease, 2) assessing the reasons and testing interventions to reduce racial variation in access the health care and utilization of health services, 3) determining appropriate interventions to improve blood pressure control for hypertensive patients treated in primary care. I have research expertise in racial variation, blood pressure control, disease management, and tele-medicine. I also have methodologic expertise in designing and testing health services interventions in multi-site clinical trials.
Key words: primary care, racial variation, quality of care, hypertension
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