Individualized multidisciplinary chronic care program can reduce the willingness for hip and knee osteoarthritis surgery

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Individualized multidisciplinary chronic care program can reduce the willingness for hip and knee osteoarthritis surgery

Teoh LS and colleagues conducted an observational study to determine the impact of an osteoarthritis-specific multidisciplinary conservative care program (OACCP) on willingness for surgery (WFS) and to recognise changes and factors in our cohort that influence and predict willingness for surgery.

In this study, consecutive OACCP participants with hip or knee OA, with WFS (willing, unsure or unwilling) data for at least two appointments were included. The proportions of unwilling versus willing/unsure patients at baseline and last appointment were compared via McNemar's test. Logistic regression was used to predict non-index joint osteoarthritis,  baseline age, gender, main language, living situation, baseline and change in pain, function, depression, body mass index and 6-min walk test (6MWT) educational status, number of comorbidities, index joint,completion of program for association with varying WFS.

As per the results, 203/409 were unwilling for the surgery, while by final appointment 234/409 were unwilling (P=0.002). Of those  206 willing/unsure at the begining, 63/206 (30.6%) became unwilling by final appointment. Index joint, completion of program, baseline and change in pain, self-reported function and 6MWT were independently related with becoming unwilling. The final model from multivariate logistic regression analysis considering becoming unwilling included baseline pain (P<0.001), change in pain (P<0.001), completion of program (P< 0.001) and age (P=0.004).

Hence, it was concluded that a conservative OA-specific treatment program that improves pain and function can lower the willingness for surgery among participants with hip or knee OA. The powerful determinants of this reduction in willingness were baseline and change in pain, completion of the program and the age of the participant.

Source:

Int J Rheum Dis. 2016

Link to the source:

https://www.ncbi.nlm.nih.gov/pubmed/27943562

Original title of article:

Observational study of the impact of an individualized multidisciplinary chronic care program for hip and knee osteoarthritis treatment on willingness for surgery.

Authors:

Teoh LS et al.

Int J Rheum Dis. 2016
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