Treatment of osteoarthritis: A role for education programmes ?
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by one or more authors of the
original publication.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2013;1(9):44 BMC Musculoskelet Disord. 2010 Oct 25;11(1):244.Exclusive Author Interview
Education programs for Osteoarthritis with Dr. Hansson
114 patients of any age with symptomatic osteoarthritis (OA) in the knee, hip, or hand with pain, stiffness, and limitation of movement in the affected joint were randomized to receive an educational program or no education. 6 months after the educational programme, patients with OA had improved self-perceived health, but had a small improvement in function with no demonstrable influence on self-efficacy.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
Sí = 1
Incierto = 0,5
No relevante = 0
No = 0
La evaluación de los criterios de información evalúa la transparencia con la que los autores informan de las características metodológicas y del ensayo dentro de la publicación. La evaluación se divide en cinco categorías que se presentan a continuación.
3/4
Randomization
2/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
4/4
Statistics
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
El Índice de Fragilidad es una herramienta que ayuda en la interpretación de hallazgos significativos, proporcionando una medida de fuerza para un resultado. El Índice de Fragilidad representa el número de eventos consecutivos que es necesario añadir a un resultado dicotómico para que el hallazgo deje de ser significativo. Un número pequeño representa un hallazgo más débil y un número grande un hallazgo más fuerte.
¿Por qué se necesitaba ahora este estudio?
Osteoarthritis (OA) affects millions of people worldwide and is a leading cause of joint replacement surgery. Patient education on self-management, exercise, or both may improve quality of life (QOL), function, and well being. Although systematic reviews have attempted to address this question in the past, the results have illustrated varying conclusions.
¿Cuál era la pregunta principal de la investigación?
Are self-management education programmes effective in improving self-efficacy, function, and self-perceived health in patients with OA in primary health care at 6 months?
- Intervention group had higher EQ5D levels in all dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression) (p<0.001)
- There was no significant difference in Arthritis Self-Efficacy Scale between the two groups
- There was no significant difference in upper extremity function.
- In lower extremity function, only one of the five outcomes, Standing one leg with eyes closed, was significantly different between the two groups with the intervention group performing better (p<0.02)
¿Qué es lo que más debo recordar?
Educational programmes, emphasizing self-management in the primary health care setting for patients with OA, are feasible and can improve a patients self-perceived health. However, these programmes have a small effect on improving function and have not been shown to influence self-efficacy.
¿Cómo afectará esto al cuidado de mis pacientes?
Clinicians should consider providing self-management educational programmes that advocate physical activity and self-management for patients with OA.
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