Abstract
The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.
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Peat G, McCarney R, Croft P (2001) Knee pain and osteoarthritis in older adults: a review of community burden and current use of primary health care. Ann Rheum Dis 60:91–97
Zhang W, Moskowitz RW, Nuki G et al (2008) OARSI recommendations for the management of hip and knee osteoarthritis, part II: OARSI evidence-based, expert consensus guidelines. Osteoarthr Cartil 16:137–162
Zhang W, Doherty M, Peat G et al (2010) EULAR evidence-based recommendations for the diagnosis of knee osteoarthritis. Ann Rheum Dis 69:483–489
Zhang W, Doherty M, Arden N et al (2005) EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR standing committee for international clinical studies including therapeutics (ESCISIT). Ann Rheum Dis 64:669–681
Peter WFH, Jansen MJ, Hurkmans EJ et al (2011) Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation. Acta Reumatol Port 36:268–281
Dutch Orthopaedic Association (2007) CBO guideline OA hip and knee (ref type: online source)
Dieppe P, Brandt KD (2003) What is important in treating osteoarthritis? Whom should we treat and how should we treat them? Rheum Dis Clin N Am 29:687–716
Moe RH, Uhlig T, Kjeken I, Hagen KB, Kvien TK, Grotle M (2010) Multidisciplinary and multifaceted outpatient management of patients with osteoarthritis: protocol for a randomised, controlled trial. BMC Musculoskelet Disord 11:253
Brand CA, Amatya B, Gordon B, Tosti T, Gorelik A (2010) Redesigning care for chronic conditions: improving hospital-based ambulatory care for people with osteoarthritis of the hip and knee. Intern Med J 40:427–436
Jordan KM, Arden NK, Doherty M et al (2003) EULAR recommendations 2003: an evidence based approach to the management of knee osteoarthritis: report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis 62:1145–1155
Kellgren JH, Lawrence JS (1957) Radiological assessment of osteo-arthrosis. Ann Rheum Dis 16:494–502
WHO Scientific Group (1992) Rheumatic diseases. World Health Organ Tech Rep Ser 816:1–59
Aaronson NK, Muller M, Cohen PD et al (1998) Translation, validation, and norming of the Dutch language version of the SF-36 health survey in community and chronic disease populations. J Clin Epidemiol 51:1055–1068
Ware JE, Snow KKM (2009) User’s manual for the SD-36v2 health survey. Advantages of norm based scoring, chap 7, pp 81–84
Cheung C, Oemar O, Oppe M, Rabin R (2010) User guide, basic information on how to use EQ-5D
Lamers LM, Stalmeier PF, McDonnell J, Krabbe PF, van Busschbach JJ (2005) Measuring the quality of life in economic evaluations: the Dutch EQ-5D tariff. Ned Tijdschr Geneeskd 149:1574–1578
Hawker GA, Davis AM, French MR et al (2008) Development and preliminary psychometric testing of a new OA pain measure—an OARSI/OMERACT initiative. Osteoarthr Cartil 16:409–414
Maillefert JF, Kloppenburg M, Fernandes L et al (2009) Multi-language translation and cross-cultural adaptation of the OARSI/OMERACT measure of intermittent and constant osteoarthritis pain (ICOAP). Osteoarthr Cartil 17:1293–1296
Klassbo M, Larsson E (2003) Hip disability and osteoarthritis outcome score. An extension of the Western Ontario and McMaster Universities osteoarthritis index. Scand J Rheumatol 32:46–51
de Groot IB, Reijman M, Terwee CB et al (2007) Validation of the Dutch version of the hip disability and osteoarthritis outcome score. Osteoarthr Cartil 15:104–109
de Groot IB, Favejee MM, Reijman M, Verhaar JA, Terwee CB (2008) The Dutch version of the knee injury and osteoarthritis outcome score: a validation study. Health Qual Life Outcomes 6:16
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee injury and osteoarthritis outcome score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28:88–96
Tijhuis GJ, Kooiman KG, Zwinderman AH, Hazes JM, Breedveld FC, Vliet Vlieland TP (2003) Validation of a novel satisfaction questionnaire for patients with rheumatoid arthritis receiving outpatient clinical nurse specialist care, inpatient care, or day patient team care. Arthritis Rheum 49:193–199
Halbert J, Crotty M, Weller D, Ahern M, Silagy C (2001) Primary care-based physical activity programs: effectiveness in sedentary older patients with osteoarthritis symptoms. Arthritis Rheum 45:228–234
Victor CR, Triggs E, Ross F, Lord J, Axford JS (2005) Lack of benefit of a primary care-based nurse-led education programme for people with osteoarthritis of the knee. Clin Rheumatol 24:358–364
Wetzels R, Van Weel C, Grol R, Wensing M (2008) Family practice nurses supporting self-management in older patients with mild osteoarthritis: a randomized trial. BMC Fam Pract 9:7
van den Hout WB, Tijhuis GJ, Hazes JM, Breedveld FC, Vliet Vlieland TP (2003) Cost effectiveness and cost utility analysis of multidisciplinary care in patients with rheumatoid arthritis: a randomised comparison of clinical nurse specialist care, inpatient team care, and day patient team care. Ann Rheum Dis 62:308–315
Mazzuca SA, Brandt KD, Katz BP, Ragozzino LR, G’sell PM (1997) Can a nurse-directed intervention reduce the exposure of patients with knee osteoarthritis to nonsteroidal antiinflammatory drugs? J Clin Rheumatol 10:315–322
Rosemann T, Joos S, Laux G, Gensichen J, Szecsenyi J (2007) Case management of arthritis patients in primary care: a cluster-randomized controlled trial. Arthritis Rheum 57:1390–1397
Mazzuca SA, Brandt KD, Katz BP, Chambers M, Byrd D, Hanna M (1997) Effects of self-care education on the health status of inner-city patients with osteoarthritis of the knee. Arthritis Rheum 40:1466–1474
Heuts PH, de Bie R, Drietelaar M et al (2005) Self-management in osteoarthritis of hip or knee: a randomized clinical trial in a primary healthcare setting. J Rheumatol 32:543–549
Coleman S, Briffa K, Conroy H, Prince R, Carroll G, McQuade J (2008) Short and medium-term effects of an education self-management program for individuals with osteoarthritis of the knee, designed and delivered by health professionals: a quality assurance study. BMC Musculoskelet Disord 9:117
Broadbent J, Maisey S, Holland R, Steel N (2008) Recorded quality of primary care for osteoarthritis: an observational study. Br J Gen Pract 58:839–843
Snijders GF, den Broeder AA, van Riel PL et al (2011) Evidence-based tailored conservative treatment of knee and hip osteoarthritis: between knowing and doing. Scand J Rheumatol 40:225–231
Gossec L, Paternotte S, Maillefert JF et al (2011) The role of pain and functional impairment in the decision to recommend total joint replacement in hip and knee osteoarthritis: an international cross-sectional study of 1909 patients. Report of the OARSI–OMERACT task force on total joint replacement. Osteoarthr Cartil 19:147–154
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Voorn, V.M.A., Vermeulen, H.M., Nelissen, R.G.H.H. et al. An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study. Rheumatol Int 33, 1821–1828 (2013). https://doi.org/10.1007/s00296-012-2662-3
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DOI: https://doi.org/10.1007/s00296-012-2662-3