Telephone-based self-management of osteoarthritis: A randomized trial

Abstract

Background: Osteoarthritis is a leading cause of pain and disability, and self-management behaviors for osteoarthritis are underutilized.

Objective: To examine the effectiveness of a telephone-based self-management intervention for hip or knee osteoarthritis in a primary care setting.

Design: Randomized clinical trial with equal assignment to osteoarthritis self-management, health education (attention control), and usual care control groups. (ClinicalTrials.gov registration number: NCT00288912)

Setting: Primary care clinics in a Veterans Affairs Medical Center.

Patients: 515 patients with symptomatic hip or knee osteoarthritis.

Intervention: The osteoarthritis self-management intervention involved educational materials and 12 monthly telephone calls to support individualized goals and action plans. The health education intervention involved nonosteoarthritis educational materials and 12 monthly telephone calls related to general health screening topics.

Measurements: The primary outcome was score on the Arthritis Impact Measurement Scales-2 pain subscale (range, 0 to 10). Pain was also assessed with a 10-cm visual analog scale. Measurements were collected at baseline and 12 months.

Results: 461 participants (90%) completed the 12-month assessment. The mean Arthritis Impact Measurement Scales-2 pain score in the osteoarthritis self-management group was 0.4 point lower (95% CI, -0.8 to 0.1 point; P = 0.105) than in the usual care group and 0.6 point lower (CI, -1.0 to -0.2 point; P = 0.007) than in the health education group at 12 months. The mean visual analog scale pain score in the osteoarthritis self-management group was 1.1 points lower (CI, -1.6 to -0.6 point; P < 0.001) than in the usual care group and 1.0 point lower (CI, -1.5 to -0.5 point; P < 0.001) than in the health education group. Health care use did not differ across the groups.

Limitation: The study was conducted at 1 Veterans Affairs Medical Center, and the sample consisted primarily of men.

Conclusion: A telephone-based osteoarthritis self-management program produced moderate improvements in pain, particularly compared with a health education control group.

Primary funding source: U.S. Department of Veterans Affairs Health Services Research and Development Service.