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THU0721-HPR Multidisciplinary educational program for patients with HIP- or KNEE-OA: results of a pilot study
  1. A Claassen1,
  2. H Schers2,
  3. S Koëter3,
  4. J Botman4,
  5. W Rijnen5,
  6. W Noort-van der Laan1,
  7. C van den Ende1,
  8. on behalf of projectteam “Towards a regional approach of osteoarthritis”
  1. 1Rheumatology, Sint Maartenskliniek
  2. 2Primary and Community Care, Radboud University Medical Center
  3. 3Orthopaedic Surgery, Canisius Wilhelmina Hospital
  4. 4Stichting Gezondheidscentrum de Kroonsteen - de Vuursteen
  5. 5Orthopaedic Surgery, Radboud University Medical Center, Nijmegen, Netherlands

Abstract

Background Providing relevant disease-related and self-management related information helps patients to timely seek contact with care providers and become actively involved in their own care process. A problem recognized in the area of Nijmegen, the Netherlands is the conflicting information about OA which is disseminated by different health professionals and health organizations. Therefore, health professionals from primary care, multiple hospitals and health organisations decided to work together and develop an educational program based on a structured inventory of informational needs and on consensus-based information addressing those needs.

Objectives To determine preliminary effects of a multidisciplinary patient educational program on health care utilization (primary outcome) and on body mass index (BMI), self-efficacy, knowledge on OA and treatment, illness perceptions, pain and functioning and physical activity.

Methods A total of 146 participants attended 11 organized courses. The educational program consisted of 2 meetings, provided by a physiotherapist, a general practitioner (GP) and an orthopaedic surgeon or specialized nurse. The program comprised education on OA, treatment options and self-management, tips, practical assignments and aphorisms on OA which are repeated by the different course leaders. At baseline and at 3 months follow-up, the following outcome measures were assessed: contacts with different health care providers in the past 3 months, BMI (kg/m2), self-efficacy (10–40), knowledge on OA and treatment (0–22), illness perceptions (0–100), pain and functioning (0–100) and physical activity (min/week). Paired-sample t-tests and McNemar's test were used to estimate the preliminary effects of the program on primary and secondary outcomes.

Results A total of 144 participants agreed to participate in this study, 108 (75%) participants filled out both questionnaires. The mean (SD) age of the participants was 69.1 (10.2) years with 62.5% being female. Fifty-six percent of the participants had experienced their OA symptoms for less than 5 years. We found a significant decrease in proportion of patients who had visited their GP in the past 3 months (40.7% to 25.0%, p-value 0.02). Also, we observed a statistically significant decrease in proportion of patients who visited the physiotherapist in the past 3 months, (36.1% to 25.0%). Illness perceptions changed positively (95% CI: 0.4 – 3.4), and knowledge on OA and treatment options improved (95% CI: -3.0 - -1.6). No changes in pain, functioning and self-efficacy were found. However, a trend towards a decrease in BMI and an increase in physical activity was seen.

Conclusions Results of this study show that collaborating with multiple health professionals to provide patients with clear information on OA, treatment and self-management options in a multidisciplinary educational program, can result in differences in health care utilization and have positive effects on illness perceptions and knowledge on OA. A randomized controlled trial is needed to confirm these results.

Disclosure of Interest None declared

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