Abstract
Background: Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia. Methods: A parallel-group unblinded randomized controlled trial involving 300 patients was conducted in two hospital orthopedics clinics in Malaysia. Patients were randomly assigned to receive cognitive behavioral-based group therapy (n = 150) or no further intervention (n = 150). The primary outcome was the change from baseline in knee pain as determined by the Knee injury and Osteoarthritis Outcome Score (KOOS) at 6 months. The data collected were analyzed by covariate-adjusted mixed design repeated measures analysis of variance. All analyses were performed under the terms of intention-to-treat. Results: At 6 months, mean change from baseline in the KOOS knee pain score was 0.6 points (95% CI −1.73 to 2.94) in the control group and 8.9 points (95% CI 6.62 to 11.23) (denoting less knee pain intensity) in the intervention group (significant treatment effect p < 0.0001). Patients treated with such an approach also experienced significant improvement in functional ability when performing activities of daily living and had improved ability to cope with depression, anxiety and pain catastrophizing. Conclusion: The intervention module delivered by healthcare professionals had a sustained effect on knee OA pain and functionality over 6 months, thereby leading to an overall improvement in psychological well-being, thus benefitting most of the Malaysian knee OA patients.
Highlights
Osteoarthritis (OA) is a highly prevalent chronic disabling joint disease that affects one in eight adults globally [1]
This study examined the cognitive behavioral-based therapy module implemented by nurses and physiotherapists in managing knee osteoarthritic patients
The findings showed that patients treated with such an approach experienced significant relief in knee pain, improvement in functional ability when performing activities of daily living and had improved ability to cope with depression and anxiety as well as better response to pain catastrophizing
Summary
Osteoarthritis (OA) is a highly prevalent chronic disabling joint disease that affects one in eight adults globally [1]. It mainly affects the knee joint [2], causing pain and functional disability [3]. Knee OA is a huge burden on the patient. Conventional interventions fail to treat OA completely while surgical interventions such as. Psychosocial interventions for patients with osteoarthritis (OA) of the knee to reduce pain and improve physical and psychological functioning are still lacking in Malaysia. All analyses were performed under the terms of intention-to-treat. Results: At 6 months, mean change from baseline in the KOOS knee pain score was
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