The Trapeziometacarpal Arthrosis Symptoms and Disability questionnaire is a recently developed disease-specific instrument designed to measure patient-reported symptoms. Our aim was to establish a minimal clinically important difference for this questionnaire. This prospective study included 95 patients undergoing operative ( n = 39) or non-operative ( n = 56) treatments for primary trapeziometacarpal osteoarthritis. Patients completed a battery of tests including the Trapeziometacarpal Arthrosis Symptoms and Disability questionnaire at the initial clinic visit and follow-up visits. Two anchor-based methods were used to arrive at the minimal clinically important difference. Twenty-four scores met criteria for minimal clinically important change, with a median overall score rounding to 15 points. This finding is an important step in facilitating the application of this disease-specific instrument in practice. Level of evidence III
Background: Despite increased public awareness to dispose of unused narcotics, opioids prescribed postoperatively are retained, which may lead to drug diversion and abuse. This study assessed retention of unused opioids among hand surgery patients and describes disposal methods and barriers. Methods: Participants undergoing hand surgery were given an opioid disposal information sheet preoperatively (N = 222) and surveyed postoperatively to assess disposal or retention of unused opioids, disposal methods, and barriers to disposal. A binomial logistic regression was conducted to assess whether age, sex, pain intensity, and/or the type of procedure were predictors of opioid disposal. Results: There were 171 patients included in the analysis (n = 51 excluded; finished prescription or continued opioid use for pain control). Unused opioids were retained by 134 patients (78%) and disposal was reported by 37 patients (22%). Common disposal methods included returning opioids to a pharmacy (49%) or mixing them with an unwanted substance (24%). Reasons for retention included potential future use (54%), inconvenient disposal methods (21%), or keeping an unfilled prescription (9%). None of the patient factors analyzed (age, sex, type of procedure performed, or pain score) were predictors of disposal of unused narcotics ( P > .05). Conclusions: Most patients undergoing hand surgery retained prescribed opioids for future use or due to impractical disposal methods. The most common disposal methods included returning narcotics to a pharmacy or mixing opioids with unwanted substances. Identifying predictors of disposal may provide important information when developing strategies to increase opioid disposal.
PurposeNon-operative management of trapeziometacarpal osteoarthritis (TMOA) demonstrates only short-term symptomatic alleviation, and no approved disease modifying drugs exist to treat this condition. A key issue in these patients is that radiographic disease severity can be discordant with patient reported pain, illustrating the need to identify molecular mediators of disease. This study characterizes the biochemical profile of TMOA patients to elucidate molecular mechanisms driving TMOA progression.MethodsPlasma from patients with symptomatic TMOA undergoing surgical (n=39) or non-surgical management (n=44) with 1-year post-surgical follow-up were compared using a targeted panel of 27 cytokines. Radiographic (Eaton-Littler), anthropometric, longitudinal pain (VAS, TASD, quick DASH) and functional (key pinch, grip strength) data were used to evaluate relationships between structure, pain, and systemic cytokine expression. Principal Component Analysis was used to identify clusters of patients.ResultsPatients undergoing surgery had greater BMI as well as higher baseline quick DASH, TASD scores. Systemically, these patients could only be distinguished by differing levels of Interleukin-7 (IL-7), with an adjusted odds ratio of 0.22 for surgery for those with increased levels of this cytokine. Interestingly, PCA analysis of all patients (regardless of surgical status) identified a subset of patients with an “inflammatory” phenotype, as defined by a unique molecular signature consisting of thirteen cytokines.ConclusionOverall, this study demonstrated that circulating cytokines are capable of distinguishing TMOA disease severity, and identified IL-7 as a target capable of differentiating disease severity with higher levels associated with a decreased likelihood of TMOA needing surgical intervention. It also identified a cluster of patients who segregate based on a molecular signature of select cytokines.
Background: This study aimed to assess the responsiveness of the Trapeziometacarpal Arthrosis Symptoms and Disability (TASD) questionnaire after corticosteroid injections and operative management for trapeziometacarpal osteoarthritis (TMC-OA). Methods: This longitudinal cohort study included patients with TMC-OA who underwent treatment (corticosteroid injection or surgery). Measurements occurred at baseline and follow-up time points: 6 weeks, 3 months, 6 months, and 1 year. Patient measures were collected electronically using a data repository platform. The TASD is a validated psychometric patient-administered scale. We examined responsiveness by correlating the TASD scores with another known effective indicator of change (shortened Disabilities of the Arm, Shoulder, and Hand [QuickDASH]). Repeated score measurements over time were analyzed using analysis of variance, and correlations between questionnaires were reported with repeated measures correlation and Pearson correlation coefficients. Results: The nonsurgical cohort undergoing corticosteroid injections included 31 (66%) women and 16 (34%) men, and the surgical cohort included 29 (71%) women and 12 (29%) men. Both the QuickDASH and the TASD captured a statistically significant improvement in symptom burden postoperatively ( P < .0001 for both questionnaires), whereas no statistical significance was noted after corticosteroid injections ( P = .45 and P = .34, respectively). There was a strong correlation between QuickDASH and TASD questionnaires ( r = 0.87, P < .0001). Conclusions: The TASD is a promising TMC-OA–specific questionnaire to capture responsiveness following treatment, particularly following surgery. The responsiveness of TASD was demonstrated in the TMC-OA cohort. Further research is needed to define a minimal clinically important difference.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.