Low intensity intervention yields modest benefit in knee and hip osteoarthritis

The combined patient and provider intervention resulted in modest improvement in self-reported physical function in patients with hip and knee osteoarthritis. Allen, Yancy, Bosworth, et al.

Medical News Today 27 December 2015

A low-intensity combined patient and doctor intervention may help to improve physical function and physical activity for patients with knee or hip osteoarthritis. The research is published in the Annals of Internal Medicine.

Adequate management of hip and knee osteoarthritis requires both medical and behavioral strategies, but recommended therapies are underused. Researchers sought to determine if a combined patient and provider intervention could improve osteoarthritis outcomes.

Researchers randomly assigned 300 patients and providers at a cluster of 30 VA outpatient clinics to either an intervention group plus usual care or usual care alone. The telephone-based patient intervention focused on weight management, physical activity, and cognitive behavioral pain management. The provider intervention involved delivery of patient-specific osteoarthritis treatment recommendations to primary care providers through electronic medical records.

At 12 months, patients in the intervention group reported modest improvements in physical function and physical activity, two important components of ostePurge cacheoarthritis management. Providers in the intervention group increased use of proven therapies, especially referrals for behavioral and rehabilitative programs. The authors note that the intervention was low-intensity. They suggest that higher-intensity interventions are needed to make more meaningful improvements in outcomes.

Source Medical News Today

References

A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial, Kelli D. Allen, PhD; William S. Yancy Jr., MD, MHS; Hayden B. Bosworth, PhD; Cynthia J. Coffman, PhD; Amy S. Jeffreys, MStat; Santanu K. Datta, PhD, MHS; Jennifer McDuffie, PhD; Jennifer L. Strauss; and Eugene Z. Oddone, MD, MHSc. Ann Intern Med. Published online 22 December 2015 doi:10.7326/M15-0378.

Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial, Messier SP, Mihalko SL, Legault C, Miller GD, Nicklas BJ, DeVita P, Beavers DP, Hunter DJ, Lyles MF, Eckstein F, Williamson JD, Carr JJ, Guermazi A, Loeser RF. JAMA. 2013 Sep 25;310(12):1263-73. doi: 10.1001/jama.2013.277669. [Citation thanks to Caitlyn Hui and Sai Folmsbee in 2 Minute Medicine]

Managing Hip and Knee Osteoarthritis with Exercise: What is the Best Prescription? Iversen MD. Ther Adv Musculoskelet Dis. 2010 Oct;2(5):279-90. doi: 10.1177/1759720X10378374. Full text