Background People with little or no education more often develop osteoarthritis (OA) and are less able to cope with their disease. Physically hard work and an often unhealthy lifestyle are predisposing factors. OA often results in a life in pain, disability, loss of quality of life and dropping out of the labour market. For the community it also has high economic impact in terms of long-term sick leaves, employment and support allowances, hospitalisations and demand for health care in general. Therefore The Danish Rheumatism Association together with Hvidovre Municipality initiated a project, which received funding from the funds of Danish Health and Medicines Authority for the prevention of social inequality in the healthcare systems. The project was carried out from December 2012 to November 2014.
Objectives The aim of the project was to investigate whether an evidence-based education and training program for people with knee and/or hip OA (GLA:D) is effective and implementable on a municipal level.
Methods 61 potential participants were enrolled into the education and training program GLA:D, 2 were excluded and 6 dropped out, leaving 53 to complete the program. The program consisted of 3 hours of patient education followed by supervised training twice a week for 6 weeks and a potential of dietary advice. All participants experienced pain from knees and/or hips, the age ranged from 37 to 85 years, they did not have any or little education and 52.7% were obese (BMI≥30). The participants were divided into 5 groups with a maximum of 12 participants in each group. Participants in group 1 to 3 were primarily pensioned while the participants in group 4 and 5 had association to the labour market (about half of them were on sick leave). Various forms of recruitment strategies were tested. The project was evaluated at three levels by University of Southern Denmark: 1) Quantitative impact measurement at the individual level by questionnaires and physical tests at baseline and again after 3 and 12 months. 2) Qualitative studies on how the participants experienced the program. 3) A process evaluation of the implementation of the project.
Results The participants experienced a reduction in pain and an improved physical function and quality of life. All participants experienced clinically relevant improvements, in particular the participants with association to the labour market. Group 4 and 5 reduced pain by 47% compared to 15% for group 1-3. The participants were motivated by the team spirit to join the training. At the same time competition encouraged them to exercises at home too. The process evaluation showed that the project was carried out based on a well-designed program. There was almost no need for changes in the program during the project. The greatest challenge was recruiting participants with association to the labour market.
Conclusions The project showed that GLA:D is effective, the participants were satisfied with the program and it is possible to implement in the municipality. The project therefore has a potential to improve the social inequality among people with OA in the health system.
Disclosure of Interest None declared