Evaluating the design and reporting of pragmatic trials in osteoarthritis research

Ali, Shabana Amanda; Kloseck, Marita; Lee, Karen; Walsh, Kathleen E.; MacDermid, Joy C.; Fitzsimmons, Deborah

doi:10.1093/rheumatology/kex050

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…There are several strategies that can be used to mitigate symptoms of osteoarthritis, including exercise, strength training, and weight management, among others [ 10 ]. The challenge lies in effective implementation of these strategies among community-dwelling older adults [ 11 ]. Existing self-management programs that require older adults to take responsibility for managing their osteoarthritis may be lacking critical factors that facilitate adoption of disease management strategies.…”

Section: Introductionmentioning

confidence: 99%

Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

et al. 2018

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Systematic reviews of self-management programs for osteoarthritis suggest minimal evidence of benefit and indicate substantial heterogeneity in interventions. The purpose of this scoping review was to describe the nature of self-management interventions provided to patients with osteoarthritis focusing on the inclusion and type of education and social support components. We searched PsycINFO, EMBASE, MEDLINE, and Cochrane Library databases from 1990 to 2016 to identify studies addressing community-based management strategies for osteoarthritis that included aspects of disease-specific education and ongoing social support. Results are presented as a narrative synthesis to facilitate integration of diverse evidence. Data were extracted from 23 studies that met our inclusion and exclusion criteria, describing complex, multicomponent interventions for osteoarthritis. All studies included education components, and 18 of these were osteoarthritis-specific. Social support was most often offered through peers and health care professionals, but also through exercise trainers/instructors and researchers, and lasted between 5 and 52 weeks. We charted positive social interaction offered by peers in group settings and emotional/informational support offered by health care professionals. Overall, descriptions of self-management provided limited documentation of the rationale or content of the programs. This suggests that more precise definitions of the theoretical underpinnings, components, and mechanisms would be useful for greater insight into best practices for osteoarthritis self-management programs.

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Section: Introductionmentioning

confidence: 99%

Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

et al. 2018

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“… 2 Current research is focused on identifying the causes of OA, improving treatment, and reducing the burden of the disease, 3 yet there remains a breakdown in the translation and implementation of OA information from care providers to community-dwelling seniors. 4 Efforts to improve this can be strengthened by including the patient perspective. 5 …”

Section: Introductionmentioning

confidence: 99%

Patient perspectives on improving osteoarthritis management in urban and rural communities

Ali¹,

Walsh²,

Kloseck³

2018

JPR

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IntroductionAlthough there is no cure for osteoarthritis (OA), there are lifestyle modifications that can mitigate symptoms such as pain, and improve management of the disease. This information is not always translated to community-dwelling seniors. Individuals in rural areas often face additional challenges due to geographic isolation and decreased access to community services.MethodsWe used qualitative research methodology (hermeneutic phenomenology) to better understand the lived experiences of urban and rural community-dwelling seniors diagnosed with OA. We explored their sources of information about OA, how they manage their OA pain, and how OA management could be improved in the community. Purposeful sampling was used to recruit 20 information-rich participants (11 urban, 9 rural) in Ontario, Canada. All participants were aged >65 and diagnosed with OA. Semi-structured interviews were conducted, audio recorded, and transcribed verbatim. NVivo 11 Pro qualitative software was used to code transcripts.ResultsThematic analysis revealed 9 key themes where 8 were common to urban and rural participants, and 1 was unique to rural participants. Most significant among the common themes was the description of the social network as a source of OA information, the trial-and-error approach used for OA management, and the individual contextualization of OA management. Our results suggest that there are several common experiences among urban- and rural-dwelling seniors living with OA, including the desire for support over time, but also a unique experience to rural-dwelling seniors, namely lack of access to local care.ConclusionThese findings can be used to improve translation of OA information in both urban and rural communities in Canada, highlighting that common strategies may be effective in different contexts for this disease.

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“…Moreover, the evidence from exercise trials is limited by the inability to have an appropriate control arm since a true placebo group is not possible (i.e., participants know whether they are exercising). One way to overcome this “control condition” challenge may be to design more pragmatic exercise trials ( 28 ), including comparison of different exercise types, and variations in intensity, frequency, and duration of exercise. It would also be beneficial to have clearly defined hypotheses about the mechanisms through which exercise improves OA outcomes to support more tailored exercise interventions in future studies.…”

Section: Introductionmentioning

confidence: 99%

Can genetics guide exercise prescriptions in osteoarthritis?

Espin‐Garcia

Baghel²,

Brar³

et al. 2022

Front. Rehabilit. Sci.

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Osteoarthritis (OA) is the most common form of arthritis and has a multifactorial etiology. Current management for OA focuses on minimizing pain and functional loss, typically involving pharmacological, physical, psychosocial, and mind-body interventions. However, there remain challenges in determining which patients will benefit most from which interventions. Although exercise-based interventions are recommended as first-line treatments and are known to be beneficial for managing both the disease and illness of OA, the optimal exercise “prescription” is unknown, due in part to our limited understanding of the precise mechanisms underlying its action. Here we present our perspective on the potential role of genetics in guiding exercise prescription for persons with OA. We describe key publications in the areas of exercise and OA, genetics and OA, and exercise and genetics, and point to a paucity of knowledge at the intersection of exercise, genetics, and OA. We suggest there is emerging evidence to support the use of genetics and epigenetics to explain the beneficial effects of exercise for OA. We identify missing links in the existing research relating to exercise, genetics, and OA, and highlight epigenetics as a promising mechanism through which environmental exposures such as exercise may impact OA outcomes. We anticipate future studies will improve our understanding of how genetic and epigenetic factors mediate exercise-based interventions to support implementation and ultimately improve OA patient care.

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Evaluating the design and reporting of pragmatic trials in osteoarthritis research

Cited by 6 publications

References 18 publications

Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

Education and Social Support as Key Factors in Osteoarthritis Management Programs: A Scoping Review

Patient perspectives on improving osteoarthritis management in urban and rural communities

Can genetics guide exercise prescriptions in osteoarthritis?

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