Abstract
BackgroundProviding relevant information on disease and self-management helps patients to seek timely contact with care providers and become actively involved in their own care process. Therefore, health professionals from primary care, multiple hospitals and health organisations jointly decided to develop an educational program on osteoarthritis (OA). The objective of the present study was to determine preliminary effects of this OA educational program on healthcare utilization and clinical outcomes.MethodsWe developed an educational group-based program consisting of 2 meetings of 1.5 h, provided by a physiotherapist, a general practitioner (GP) and orthopaedic surgeon or specialized nurse. The program included education on OA, (expectations regarding) treatment options and self-management. Patients were recruited through searching the GPs’ electronic patients records and advertisements in local newspapers. At baseline and at 3 months follow-up participating OA patients completed questionnaires. Paired-sample t-tests, McNemar’s test and Wilcoxon Signed-Rank test were used to estimate the preliminary effects of the program.ResultsA total of 146 participants in 3 districts attended the sessions, of whom 143 agreed to participate in this study; mean age 69.1 years (SD10.2).107 (75%) participants completed both baseline and follow up assessments. The proportion of participants who had visited their GP in the 3 months after the program was lower than 3 months previous to the program (40% versus 25%, p-value 0.01). Also, we observed a decrease in proportion of patients who visited the physio- and exercise therapist, (36.1% versus 25.0%, p-value 0.02). Both illness perceptions and knowledge on OA and treatment options changed positively (Δ-1.8, 95%CI:0.4–3.4, and Δ2.4, 95%CI:-3.0 - -1.6 respectively). No changes in BMI, pain, functioning and self-efficacy were found. However, a trend towards an increase in physical activity was observed.ConclusionsOur results show that a multidisciplinary educational program may result in a decrease in healthcare utilization and has a positive effect on illness perceptions and knowledge on OA due to clear and consistent information on OA and it treatment options.Trial registrationNetherlands Trial Register (NTR5472). Registered 22 September 2015.
Highlights
Providing relevant information on disease and self-management helps patients to seek timely contact with care providers and become actively involved in their own care process
Patient characteristics In total 146 patients with knee or hip OA and 54 of their partners participated in the educational program
A total of 143 patients agreed to participate in the present study, 107 (75%) participants filled out both questionnaires, 4 were considered drop-outs, as they did not come to the intervention and did not want to continue with the study
Summary
Providing relevant information on disease and self-management helps patients to seek timely contact with care providers and become actively involved in their own care process. OA of the hip and knee is characterised by pain and stiffness which can impair daily functioning, and decrease physical activity [2]. This physical and accompanying mental burden influences the quality of life in patients with OA. There are no curative treatment options for OA, multiple effective non-surgical and surgical treatment options for reducing pain and improving movement ability and quality of life are available [2, 3]. Non-pharmacological treatment modalities include psycho-educational interventions to improve self-management, physical activity and exercise therapy, and weight reduction. Once non-surgical treatments become unsuccessful, joint replacement surgery is a cost-effective procedure that can be considered for patients with severe symptoms [3]. Joint replacement surgery is advised to be postponed as long as possible, as the lifespan of prostheses are limited [2] and the results can vary [4]
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