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BMC Public Health
Published in: BMC Public Health 1/2005

Open Access 01-12-2005 | Study protocol

Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339]

Authors: Thomas Rosemann, Thorsten Körner, Michel Wensing, Jochen Gensichen, Christiane Muth, Stefanie Joos, Joachim Szecsenyi

Published in: BMC Public Health | Issue 1/2005

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Abstract

Background

Osteoarthritis (OA) has a high prevalence in primary care. Conservative, guideline orientated approaches aiming at improving pain treatment and increasing physical activity, have been proven to be effective in several contexts outside the primary care setting, as for instance the Arthritis Self management Programs (ASMPs). But it remains unclear if these comprehensive evidence based approaches can improve patients' quality of life if they are provided in a primary care setting.

Methods/Design

PraxArt is a cluster randomised controlled trial with GPs as the unit of randomisation. The aim of the study is to evaluate the impact of a comprehensive evidence based medical education of GPs on individual care and patients' quality of life. 75 GPs were randomised either to intervention group I or II or to a control group. Each GP will include 15 patients suffering from osteoarthritis according to the criteria of ACR.
In intervention group I GPs will receive medical education and patient education leaflets including a physical exercise program. In intervention group II the same is provided, but in addition a practice nurse will be trained to monitor via monthly telephone calls adherence to GPs prescriptions and advices and ask about increasing pain and possible side effects of medication.
In the control group no intervention will be applied at all. Main outcome measurement for patients' QoL is the GERMAN-AIMS2-SF questionnaire. In addition data about patients' satisfaction (using a modified EUROPEP-tool), medication, health care utilization, comorbidity, physical activity and depression (using PHQ-9) will be retrieved.
Measurements (pre data collection) will take place in months I-III, starting in June 2005. Post data collection will be performed after 6 months.

Discussion

Despite the high prevalence and increasing incidence, comprehensive and evidence based treatment approaches for OA in a primary care setting are neither established nor evaluated in Germany. If the evaluation of the presented approach reveals a clear benefit it is planned to provide this GP-centred interventions on a much larger scale.
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Literature
1.
2.
Felson DT, Lawrence RC, Dieppe PA, Hirsch R, Helmick CG, Jordan JM, Kington RS, Lane NE, Nevitt MC, Zhang Y, Sowers M, McAlindon T, Spector TD, Poole AR, Yanovski SZ, Ateshian G, Sharma L, Buckwalter JA, Brandt KD, Fries JF: Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000, 133: 635-646.CrossRefPubMed
3.
Neville C, Fortin PR, Fitzcharles MA, Baron M, Abrahamowitz M, Du BR, Esdaile JM: The needs of patients with arthritis: the patient's perspective. Arthritis Care Res. 1999, 12: 85-95. 10.1002/1529-0131(199904)12:2<85::AID-ART3>3.0.CO;2-W.CrossRefPubMed
4.
Buckley LM, Vacek P, Cooper SM: Educational and psychosocial needs of patients with chronic disease. A survey of preferences of patients with rheumatoid arthritis. Arthritis Care Res. 1990, 3: 5-10.PubMed
5.
de Bock GH, Kaptein AA, Mulder JD: Dutch general practitioners' management of patients with distal osteoarthritic symptoms. Scand J Prim Health Care. 1992, 10: 42-46.CrossRefPubMed
6.
Felson DT, Lawrence RC, Hochberg MC, McAlindon T, Dieppe PA, Minor MA, Blair SN, Berman BM, Fries JF, Weinberger M, Lorig KR, Jacobs JJ, Goldberg V: Osteoarthritis: new insights. Part 2: treatment approaches. Ann Intern Med. 2000, 133: 726-737.CrossRefPubMed
7.
Mazieres B, Bannwarth B, Dougados M, Lequesne M: EULAR recommendations for the management of knee osteoarthritis. Report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials. Joint Bone Spine. 2001, 68: 231-240. 10.1016/S1297-319X(01)00271-8.CrossRefPubMed
8.
Warsi A, LaValley MP, Wang PS, Avorn J, Solomon DH: Arthritis self-management education programs: a meta-analysis of the effect on pain and disability. Arthritis Rheum. 2003, 48: 2207-2213. 10.1002/art.11210.CrossRefPubMed
9.
Zhang W, Doherty M, Arden N, Bannwarth B, Bijlsma J, Gunther KP, Hauselmann HJ, Herrero-Beaumont G, Jordan K, Kaklamanis P, Leeb B, Lequesne M, Lohmander S, Mazieres B, Martin-Mola E, Pavelka K, Pendleton A, Punzi L, Swoboda B, Varatojo R, Verbruggen G, Zimmermann-Gorska I, Dougados M: EULAR evidence based recommendations for the management of hip osteoarthritis: report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2005, 64: 669-681. 10.1136/ard.2004.028886.CrossRefPubMed
10.
Solomon DH, Warsi A, Brown-Stevenson T, Farrell M, Gauthier S, Mikels D, Lee TH: Does self-management education benefit all populations with arthritis? A randomized controlled trial in a primary care physician network. J Rheumatol. 2002, 29: 362-368.PubMed
11.
Grol R, Grimshaw J: From best evidence to best practice: effective implementation of change in patients' care. Lancet. 2003, 362: 1225-1230. 10.1016/S0140-6736(03)14546-1.CrossRefPubMed
12.
Grol R, Grimshaw J: Evidence-based implementation of evidence-based medicine. Jt Comm J Qual Improv. 1999, 25: 503-513.PubMed
13.
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C: Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technol Assess. 2004, 8: iii-72.CrossRefPubMed
14.
Wensing M, Broge B, Kaufmann-Kolle P, Andres E, Szecsenyi J: Quality circles to improve prescribing patterns in primary medical care: what is their actual impact?. J Eval Clin Pract. 2004, 10: 457-466. 10.1111/j.1365-2753.2004.00517.x.CrossRefPubMed
15.
Rene J, Weinberger M, Mazzuca SA, Brandt KD, Katz BP: Reduction of joint pain in patients with knee osteoarthritis who have received monthly telephone calls from lay personnel and whose medical treatment regimens have remained stable. Arthritis Rheum. 1992, 35: 511-515.CrossRefPubMed
16.
R. L, B. MO: Therapieempfehlungen. Empfehlungen zur Therapie von degenerativen Gelenkerkrankungen. 2001, Lasek R.; Mueller-Oerlinghausen B., R. L and B. MO, Ärzteschaft SA
17.
Campbell M, Grimshaw J, Steen N: Sample size calculations for cluster randomised trials. Changing Professional Practice in Europe Group (EU BIOMED II Concerted Action). J Health Serv Res Policy. 2000, 5: 12-16.PubMed
18.
Campbell MK, Mollison J, Grimshaw JM: Cluster trials in implementation research: estimation of intracluster correlation coefficients and sample size. Stat Med. 2001, 20: 391-399. 10.1002/1097-0258(20010215)20:3<391::AID-SIM800>3.0.CO;2-Z.CrossRefPubMed
19.
Rosemann T, Korner T, Wensing M, Schneider A, Szecsenyi J: Evaluation and cultural adaptation of a German version of the AIMS2-SF questionnaire (German AIMS2-SF). Rheumatology (Oxford). 2005
20.
Guillemin F, Coste J, Pouchot J, Ghezail M, Bregeon C, Sany J: The AIMS2-SF: a short form of the Arthritis Impact Measurement Scales 2. French Quality of Life in Rheumatology Group. Arthritis Rheum. 1997, 40: 1267-1274.PubMed
21.
Aberdeen U: Empirical etsimates of ICCs from changing professional practice studies. http //www abdn ac uk/hsru/epp/cluster shtml. 2005
22.
Altman R, Alarcon G, Appelrouth D, Bloch D, Borenstein D, Brandt K, Brown C, Cooke TD, Daniel W, Feldman D, .: The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip. Arthritis Rheum. 1991, 34: 505-514.CrossRefPubMed
23.
Grol R, Wensing M, Mainz J, Jung HP, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Reis S, Ribacke M, Szecsenyi J: Patients in Europe evaluate general practice care: an international comparison. Br J Gen Pract. 2000, 50: 882-887.PubMedPubMedCentral
24.
Grol R, Wensing M, Mainz J, Ferreira P, Hearnshaw H, Hjortdahl P, Olesen F, Ribacke M, Spenser T, Szecsenyi J: Patients' priorities with respect to general practice care: an international comparison. European Task Force on Patient Evaluations of General Practice (EUROPEP). Fam Pract. 1999, 16: 4-11. 10.1093/fampra/16.1.4.CrossRefPubMed
25.
Lowe B, Kroenke K, Herzog W, Grafe K: Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). J Affect Disord. 2004, 81: 61-66. 10.1016/S0165-0327(03)00198-8.CrossRefPubMed
Metadata
Title
Rationale, design and conduct of a comprehensive evaluation of a primary care based intervention to improve the quality of life of osteoarthritis patients. The PraxArt-project: a cluster randomized controlled trial [ISRCTN87252339]
Authors
Thomas Rosemann
Thorsten Körner
Michel Wensing
Jochen Gensichen
Christiane Muth
Stefanie Joos
Joachim Szecsenyi
Publication date
01-12-2005
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2005
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-5-77

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