Background Osteoarthritis (OA) is one of the most frequent chronic musculoskeletal disorders, and one of the leading causes of pain and disability. Evidence-based recommendations mostly consider single interventions, however in clinical practice, combinations of different interventions are often used, but with little evidence for their effectiveness.
Objectives To examine the efficacy of a multidisciplinary outpatient clinic, including a brief group-based educational programme, compared to an individual outpatient clinic for patients with hand, hip, knee or generalized OA after 4 months.
Methods Patients referred to a specialized rheumatology outpatient clinic with a clinical OA diagnosis were randomised to a 3.5h brief multidisciplinary group-based educational intervention followed by individual consultations, or to usual individual care. Demographic variables included age, gender, and body mass index (BMI). Primary outcome was satisfaction with the health service, evaluated on a NRS with anchors 0=extremely unsatisfied and 10=extremely satisfied. Secondary outcomes included pain, fatigue, and stiffness (NRS, 0-10), Hopkins Symptom Checklist-25 (HSCL-25, 1-4, 1 is best), Arthritis Self-Efficacy Scales (ASES, 10-100, 100 is best), Western Ontario and McMaster- (WOMAC) (0-30, 0 is best) and Australian/Canadian hand- (AUSCAN) (0-10, 0 is best) osteoarthritis indexes.
Results Of 390 patients, 86.4 % (n=337) were women, and mean (SD) age was 63.1 (8.0) years. Patients who received a multidisciplinary intervention were more satisfied with the health service, compared to controls after 4 months, with a mean difference (NRS) of -1.05 (CI -1.68;-0.43) (p<0.001). Among secondary outcomes, self-efficacy with other symptoms improved significantly compared to controls by 3.54 vs. -1.12 units (p=0.02). There were no differences in other secondary outcomes using mixed model analyses between groups at 4-month follow-up.
Conclusions Patients with OA receiving a brief multidisciplinary intervention were more satisfied with health care than controls receiving individual outpatient care. These findings support the role of multidisciplinary care in the treatment of OA.
Disclosure of Interest None Declared
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