Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2010

Open Access 01-12-2010 | Research article

Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial

Authors: Eva Ekvall Hansson, Malin Jönsson-Lundgren, Anne-Marie Ronnheden, Eva Sörensson, Åsa Bjärnung, Leif E Dahlberg

Published in: BMC Musculoskeletal Disorders | Issue 1/2010

Login to get access

Abstract

Background

Osteoarthritis (OA) is a degenerative disease, considered to be one of the major public health problems. Research suggests that patient education is feasible and valuable for achieving improvements in quality of life, in function, well-being and improved coping. Since 1994, Primary Health Care in Malmö has used a patient education programme directed towards OA. The aim of this study was to evaluate the effects of this education programme for patients with OA in primary health care in terms of self-efficacy, function and self-perceived health.

Method

The study was a single-blind, randomized controlled trial (RCT) in which the EuroQol-5D and Arthritis self-efficacy scale were used to measure self-perceived health and self-efficacy and function was measured with Grip Ability Test for the upper extremity and five different functional tests for the lower extremity.

Results

We found differences between the intervention group and the control group, comparing the results at baseline and after 6 months in EuroQol-5D (p < 0.001) and in standing one leg eyes closed (p = 0.02) in favour of the intervention group. No other differences between the groups were found.

Conclusion

This study has shown that patient education for patients with osteoarthritis is feasible in a primary health care setting and can improve self-perceived health as well as function in some degree, but not self-efficacy. Further research to investigate the effect of exercise performance on function, as well as self-efficacy is warranted.

Trial registration

The trial is registered with ClinicalTrials.gov. Registration number: NCT00979914
Appendix
Available only for authorised users
Literature
1.
Peyron JG: Epidemiologic and etiologic approach of osteoarthritis. Semin Arthritis Rheum. 1979, 8 (4): 288-306. 10.1016/0049-0172(79)90006-4.CrossRefPubMed
2.
Hawley DJ: Psycho-educational interventions in the treatment of arthritis. Baillieres Clin Rheumatol. 1995, 9 (4): 803-23. 10.1016/S0950-3579(05)80315-2.CrossRefPubMed
3.
Andersson ML, Thorstensson CA, Roos EM, Petersson IF, Heinegard D, Saxne T: Serum levels of cartilage oligomeric matrix protein (COMP) increase temporarily after physical exercise in patients with knee osteoarthritis. BMC Musculoskelet Disord. 2006, 7: 98-10.1186/1471-2474-7-98.CrossRefPubMedPubMedCentral
4.
Roos EM, Dahlberg L: Positive effects of moderate exercise on glycosaminoglycan content in knee cartilage: a four-month, randomized, controlled trial in patients at risk of osteoarthritis. Arthritis Rheum. 2005, 52 (11): 3507-14. 10.1002/art.21415.CrossRefPubMed
5.
Thorstensson CA, Roos EM, Petersson IF, Ekdahl C: Six-week high-intensity exercise program for middle-aged patients with knee osteoarthritis: a randomized controlled trial [ISRCTN20244858]. BMC Musculoskelet Disord. 2005, 6: 27-10.1186/1471-2474-6-27.CrossRefPubMedPubMedCentral
6.
Williamson L, Wyatt MR, Yein K, Melton JT: Severe knee osteoarthritis: a randomized controlled trial of acupuncture, physiotherapy (supervised exercise) and standard management for patients awaiting knee replacement. Rheumatology (Oxford). 2007, 46 (9): 1445-9. 10.1093/rheumatology/kem119.CrossRef
7.
Schrieber L, Colley M: Patient education. Best Pract Res Clin Rheumatol. 2004, 18 (4): 465-76. 10.1016/j.berh.2004.03.008.CrossRefPubMed
8.
Rosemann T, Joos S, Laux G, Gensichen J, Szecsenyi J: Case management of arthritis patients in primary care: A cluster-randomized controlled trial. Arthritis Rheum. 2007, 57 (8): 1390-7. 10.1002/art.23080.CrossRefPubMed
9.
Devos-Comby L, Cronan T, Roesch SC: Do exercise and self-management interventions benefit patients with osteoarthritis of the knee? A metaanalytic review. J Rheumatol. 2006, 33 (4): 744-56.PubMed
10.
Domaille M, Mascarenhas R, Dayal N, Kirwan J: Evaluation of the Bristol Royal Infirmary physiotherapy programme for the management of patients with osteoarthritis of the knee. Musculoskelet Care. 2006, 4 (2): 78-87. 10.1002/msc.80.CrossRef
11.
Heuts PH, de Bie R, Drietelaar M, Aretz K, Hopman-Rock M, Bastiaenen CH: Self-management in osteoarthritis of hip or knee: a randomized clinical trial in a primary healthcare setting. J Rheumatol. 2005, 32 (3): 543-9.PubMed
12.
Nunez M, Nunez E, Segur JM, Macule F, Quinto L, Hernandez MV: The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study. Osteoarthritis Cartilage. 2006, 14 (3): 279-85. 10.1016/j.joca.2005.10.002.CrossRefPubMed
13.
Yip YB, Sit JW, Fung KK, Wong DY, Chong SY, Chung LH: Impact of an Arthritis Self-Management Programme with an added exercise component for osteoarthritic knee sufferers on improving pain, functional outcomes, and use of health care services: An experimental study. Patient Educ Couns. 2007, 65 (1): 113-21. 10.1016/j.pec.2006.06.019.CrossRefPubMed
14.
Chodosh J, Morton SC, Mojica W, Maglione M, Suttorp MJ, Hilton L: Meta-analysis: chronic disease self-management programs for older adults. Annals of Internal Medicine. 2005, 143 (6): 427-38.CrossRefPubMed
15.
Walsh NE, Mitchell HL, Reeves BC, Hurley MV: Integrated exercise and self-management programmes in osteoarthritis och the hip and knee: a systematic review of effectiveness. Phys Ther Rev. 2006, 11: 289-97. 10.1179/108331906X163432.CrossRef
16.
Conaghan PG, Dickson J, Grant RL: Care and management of osteoarthritis in adults: summary of NICE guidance. BMJ (Clinical Research ed). 2008, 336 (7642): 502-3. 10.1136/bmj.39490.608009.AD.CrossRef
17.
Fransen M, Edmonds J: Reliability and validity of the EuroQol in patients with osteoarthritis of the knee. Rheumatology (Oxford). 1999, 38 (9): 807-13. 10.1093/rheumatology/38.9.807.CrossRef
18.
19.
Dolan P: Modeling valuations for EuroQol health states. Medical Care. 1997, 35 (11): 1095-108. 10.1097/00005650-199711000-00002.CrossRefPubMed
20.
Jubb RW, Tukmachi ES, Jones PW, Dempsey E, Waterhouse L, Brailsford S: A blinded randomised trial of acupuncture (manual and electroacupuncture) compared with a non-penetrating sham for the symptoms of osteoarthritis of the knee. Acupunct Med. 2008, 26 (2): 69-78. 10.1136/aim.26.2.69.CrossRefPubMed
21.
Richardson G, Kennedy A, Reeves D, Bower P, Lee V, Middleton E: Cost effectiveness of the Expert Patients Programme (EPP) for patients with chronic conditions. J Epidemiol Community Health. 2008, 62 (4): 361-7. 10.1136/jech.2006.057430.CrossRefPubMed
22.
Rolfson O, Dahlberg LE, Nilsson JA, Malchau H, Garellick G: Variables determining outcome in total hip replacement surgery. J Bone Joint Surg Br. 2009, 91 (2): 157-61. 10.1302/0301-620X.91B2.20765.CrossRefPubMed
23.
Lorig K, Chastain RL, Ung E, Shoor S, Holman HR: Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum. 1989, 32 (1): 37-44. 10.1002/anr.1780320107.CrossRefPubMed
24.
Lomi C: Evaluation of a Swedish version of the Arthritis Self-Efficacy Scale. Scandinavian Journal of Caring Sciences. 1992, 6 (3): 131-8.CrossRefPubMed
25.
Lomi C, Nordholm LA: Validation of a Swedish version of the Arthritis Self-efficacy Scale. Scandinavian Journal of Rheumatology. 1992, 21 (5): 231-7. 10.3109/03009749209099230.CrossRefPubMed
26.
Mannerkorpi K, Svantesson U, Carlsson J, Ekdahl C: Tests of functional limitations in fibromyalgia syndrome: a reliability study. Arthritis Care Res. 1999, 12 (3): 193-9. 10.1002/1529-0131(199906)12:3<193::AID-ART6>3.0.CO;2-N.CrossRefPubMed
27.
Thorstensson CA, Petersson IF, Jacobsson LT, Boegard TL, Roos EM: Reduced functional performance in the lower extremity predicted radiographic knee osteoarthritis five years later. Ann Rheum Dis. 2004, 63 (4): 402-7. 10.1136/ard.2003.007583.CrossRefPubMedPubMedCentral
28.
Bremander AB, Dahl LL, Roos EM: Validity and reliability of functional performance tests in meniscectomized patients with or without knee osteoarthritis. Scandinavian Journal of Medicine & Science in Sports. 2007, 17 (2): 120-7.
29.
Jarnlo GB, Thorngren K-G: Standing balance in hip fracture patients. Acta Orthop Scand. 1991, 62 (5): 427-34. 10.3109/17453679108996638.CrossRefPubMed
30.
Ekvall Hansson E, Mansson NO, Ringsberg KA, Hakansson A: Dizziness among patients with whiplash-associated disorder: a randomized controlled trial. J Rehabil Med. 2006, 38 (6): 387-90. 10.1080/16501970600768992.CrossRefPubMed
31.
Hansson EE, Mansson NO, Hakansson A: Effects of specific rehabilitation for dizziness among patients in primary health care. A randomized controlled trial. Clinical Rehabilitation. 2004, 18 (5): 558-65. 10.1191/0269215504cr771oa.CrossRefPubMed
32.
Harrison EL, Duenkel N, Dunlop R, Russell G: Evaluation of single-leg standing following anterior cruciate ligament surgery and rehabilitation. Physical Therapy. 1994, 74 (3): 245-52.PubMed
33.
Dellhag B, Bjelle A: A Grip Ability Test for use in rheumatology practice. J Rheumatol. 1995, 22 (8): 1559-65.PubMed
34.
Bjork MA, Thyberg IS, Skogh T, Gerdle BU: Hand function and activity limitation according to health assessment questionnaire in patients with rheumatoid arthritis and healthy referents: 5-year followup of predictors of activity limitation (The Swedish TIRA Project). J Rheumatol. 2007, 34 (2): 296-302.PubMed
35.
Hansson EE, Sorensson E, Ronnheden AM, Lundgren M, Bjarnung A, Dahlberg LE: [Arthritis school in primary health care. A pilot study of 14 years of experiences from Malmo]. Lakartidningen. 2008, 105 (32-33): 2175-7.PubMed
36.
Bohannon RW, Larkin PA, Cook AC, Gear J, Singer J: Decrease in timed balance test scores with aging. Physical Therapy. 1984, 64 (7): 1067-70.PubMed
37.
Pickard AS, Neary MP, Cella D: Estimation of minimally important differences in EQ-5D utility and VAS scores in cancer. Health Qual Life Outcomes. 2007, 5: 70-10.1186/1477-7525-5-70.CrossRefPubMedPubMedCentral
38.
Altman D: Practical statistics for medical research. 1991, New York: Chapman&Hall/CRC, 9
39.
Svensson E: Guidelines to statistical evaluation of data from rating scales and questionnaires. J Rehabil Med. 2001, 33 (1): 47-8. 10.1080/165019701300006542.CrossRefPubMed
40.
Eberhardt K, Sandqvist G, Geborek P: Hand function tests are important and sensitive tools for assessment of treatment response in patients with rheumatoid arthritis. Scandinavian Journal of Rheumatology. 2008, 37 (2): 109-12. 10.1080/03009740701747129.CrossRefPubMed
41.
Xie F, Li SC, Luo N, Lo NN, Yeo SJ, Yang KY: Comparison of the EuroQol and short form 6D in Singapore multiethnic Asian knee osteoarthritis patients scheduled for total knee replacement. Arthritis Rheum. 2007, 57 (6): 1043-9. 10.1002/art.22883.CrossRefPubMed
42.
Shaw WS, Linton SJ, Pransky G: Reducing sickness absence from work due to low back pain: how well do intervention strategies match modifiable risk factors?. Journal of Occupational Rehabilitation. 2006, 16 (4): 591-605. 10.1007/s10926-006-9061-0.CrossRefPubMed
43.
Solomon DH, Warsi A, Brown-Stevenson T, Farrell M, Gauthier S, Mikels D: Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. J Rheumatol. 2002, 29 (2): 362-8.PubMed
44.
Hay EM, Foster NE, Thomas E, Peat G, Phelan M, Yates HE: Effectiveness of community physiotherapy and enhanced pharmacy review for knee pain in people aged over 55 presenting to primary care: pragmatic randomised trial. BMJ (Clinical Research ed. 2006, 333 (7576): 995-10.1136/bmj.38977.590752.0B.CrossRef
45.
Unnebrink K, Windeler J: Intention-to-treat: methods for dealing with missing values in clinical trials of progressively deteriorating diseases. Statistics in Medicine. 2001, 20 (24): 3931-46. 10.1002/sim.1149.CrossRefPubMed
Metadata
Title
Effect of an education programme for patients with osteoarthritis in primary care - a randomized controlled trial
Authors
Eva Ekvall Hansson
Malin Jönsson-Lundgren
Anne-Marie Ronnheden
Eva Sörensson
Åsa Bjärnung
Leif E Dahlberg
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2010
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/1471-2474-11-244

Other articles of this Issue 1/2010

BMC Musculoskeletal Disorders 1/2010 Go to the issue

Study protocol

PRevalence of Abuse and Intimate Partner Violence Surgical Evaluation (P.R.A.I.S.E.): rationale and design of a multi-center cross-sectional study.

Research article

German translation and external validation of the Radboud Skills Questionnaire in patients suffering from Complex Regional Pain Syndrome 1

Case report

Undifferentiated spondyloarthritis following allogeneic stem cell transplantation

Study protocol

A randomized clinical trial of the effectiveness of mechanical traction for sub-groups of patients with low back pain: study methods and rationale

Study protocol

Warwick Hip Trauma Study: a randomised clinical trial comparing interventions to improve outcomes in internally fixed intracapsular fractures of the proximal femur. Protocol for The WHiT Study

Research article

Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study