Design of a randomized trial of a multidisciplinary intervention for knee osteoarthritis: Pharmacist Initiated Intervention Trial in Osteoarthritis (PhIT-OA)

Abstract

3 3 Arthritis is the leading cause of disability in North America, with osteoarthritis (OA) the most prevalent disease within this classification. In Canada, the economic impact of musculoskeletal disease is second only to cardiovascular disease. It is estimated that, in the next 10 to 20 years, the prevalence of OA will increase by 50%, resulting in a large personal and societal burden. Knee OA, in particular, is common and disabling. Evidence-based management of knee OA involves the use of both nonpharmacological and pharmacological approaches. Recent studies, however, have shown gaps in identifying knee OA and in delivering the appropriate interventions. In the Pharmacist Identification of New, Diagnostically confirmed OA (PhIND-OA) study, we demonstrated that pharmacists could identify people with previously undiagnosed knee OA. A recent randomized controlled trial by Hay and colleagues indicated that enhanced pharmacist medication review was as effective as exercise in the short-term management of knee pain, and both were more effective than usual care. A strategy, therefore, that uses pharmacists to identify those individuals in the community with knee OA in order to perform a medication review and to provide a referral to other health care practitioners (i.e., primary care physicians and physiotherapists) may prove effective in addressing the care gap for knee OA. We hypothesize that R E S E A R C H I N P R O G R E S S