Background The involvement of patients and public in contributing to the design of clinical research is recognised as good practice and helps to ensure that what matters most to patients is acknowledged and integrated into clinical effectiveness trial design. The Osteoarthritis Thumb Therapy Trial (OTTER) is a pilot randomised controlled trial funded by Arthritis Research UK (Trial 19400).
It is known that health care professionals’ and patients’ views differ on functional performance in arthritis (Wylde et al 2006)and many standardised hand base patient reported outcomes do not account for what matters most to patients (Stamm 2009). Therefore from the very start of the design and development of the OTTER trial we sought the opinions of people with thumb base OA to inform what was included in patient intervention and outcome measurement.
Objectives This paper reports on the involvement of our OTTER trial patient partners in identifying what are the most important functions for their daily life, what tasks are the most difficult to perform and what personal strategies are most effective for managing these when living with thumb base OA.
Methods An advert was published “Arthritis Today” (Summer 2012) seeking patient partners with thumb base OA to contribute to our patient involvement in our OTTER trial design. One hundred and twenty four people responded to register an interest in joining a national PPI data base for people with thumb base OA. A questionnaire survey was forwarded asking people to identify; what was considered to be i) the most important hand function tasks in daily life ii) the most difficult hand functional tasks iii) the most effective strategies for thumb base pain relief? Data were categorized and coded using content analysis by one researcher (KH) and independently checked by another (JA). Key themes were subsequently identified, discussed and agreed independently by both researchers.
Results Nine men and 42 women, aged between 47 and 97 years (mean 70 years) responded. All respondents experienced localized thumb base pain and thumb base OA. Respondents reported that hobbies related to physical exercise (28%) and craft activities (27%) were most important to them. The most important hand function tasks were continuing hobbies (34%) and undertaking general domestic activities (31%).
The most difficult hand functional tasks identified were domestic tasks including food preparation (37%) and general domestic tasks (31%).
The most effective strategies for thumb base pain relief were taking prescription and non-prescription medicines (34%) and exercise and massage (28%).
Conclusions The above results guide the OTTER team in developing the content of trial interventions that address what matters most to patients and informs the inclusion of outcome measures that include important leisure activities and kitchen and general domestic tasks ADL tasks.
References Stamm, T. et al. Patient perspective of hand osteoarthritis in relation to concepts covered by instruments measuring functioning: a qualitative European multicentre study.Annals of the Rheumatic Diseases, 2009; 68: 1453-1460
Wylde V. et al. Personal impact of disability in OA: patient, professional and public values. Musculoskeletal Care, 2006; 4(3) 152-166
Disclosure of Interest None Declared
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