Lack of Efficacy of Interventions on Osteoarthritis Outcomes
The patient intervention focused on weight management, physical activity, and cognitive-behavioral pain management.
HealthDay News -- Patient- and provider-based interventions do not improve osteoarthritis outcomes, according to a study published online January 17 in the Annals of Internal Medicine.1
Kelli D. Allen, PhD, from the University of North Carolina at Chapel Hill, and colleagues examined whether patient-based, provider-based, and patient-provider interventions could improve osteoarthritis outcomes. A total of 537 outpatients with symptomatic hip or knee osteoarthritis from 10 Duke University Health System community-based primary care clinics were randomized to patient, provider, or patient-provider interventions. The patient intervention focused on weight management, physical activity, and cognitive-behavioral pain management; the provider intervention included electronic delivery of patient-specific osteoarthritis treatment recommendations to providers.
The researchers found that, compared with usual care, there were no significant differences in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score changes from baseline to 12 months in the patient (−1.5), provider (2.5), or patient-provider (−0.7) intervention groups. At 12 months, all groups had improvements in WOMAC scores (−3.7 to −7.7). Compared with usual care, there were no differences in objective physical function or depressive symptoms in any of the intervention groups at 12 months.
"Contrary to a previous study of a combined patient and provider intervention for osteoarthritis in a Department of Veterans Affairs medical center, this study found no statistically significant improvements in the osteoarthritis intervention groups compared with usual care," the authors write.
One author disclosed financial ties to the pharmaceutical industry; one author disclosed financial ties to Weight Watchers International.
- Allen KD, Oddone EZ, Coffman CJ, et al. Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial. Ann Intern Med. 2017. doi: 10.7326/M16-1245