PARQVE-Project Arthritis Recovering Quality of Life by Means of Education Short-term Outcome in a Randomized Clinical Trial

Abstract

Arthritisde Rezende et al., J Arthritis 2013, 2:2 http://dx.doi. org/10.4172/2167-7921.1000113 Keywords: Osteoarthritis; Knee; Education; Quality of life; Treatment outcome; Musculoskeletal pain IntroductionOsteoarthritis is the most frequent form of arthritis and the main cause of chronic disability [1]. The disease increases with longevity and obesity [2][3][4]. Gonarthritis is among the most prevalent and disabling types of OA [5]. The bilateral knee OA is more frequent than unilateral affecting 5% versus 2%, respectively of those between 45 and 74 years [6]. Of 63 patients followed for 11 years, 12 of each 13 developed knee OA counter lateral [7].In Brazil, according to information from PNAD 2003 (National Survey of Households), 29.9% of the population reported to be suffering from at least one chronic disease (disease of spine or back, arthritis or rheumatism, cancer, diabetes or hyperglycemia, bronchitis or asthma, hypertension, heart disease, chronic kidney disease, depression, tuberculosis, tendinitis or tenosynovitis and cirrhosis), reaching 75.5% of the elderly. From PNAD 2008, the prevalence of arthritis or rheumatism corresponds to 5.7% of Brazil's population [8].OARSI guidelines exalts that an optimal management of OA requires a combination of pharmacological and non-pharmacological modalities, such as educational programs [9]. A meta-analysis with eleven studies and three other randomized controlled trials (not included in this meta-analysis) undertaken in Sweden, France and in the United Kingdom (UK), showed limited improvement in pain and function. The UK study showed no superiority of a self-management course when an educational booklet was given [10][11][12][13]. However, it is feasible in a primary care setting and it can improve self-perceived health as well as function and a structured consultation program for patients with knee OA resulted in short term improvement in weight loss and time spent on physical activity [11,12]. A telephonebased osteoarthritis self-management program produced moderate improvements in pain, particularly compared with a health education control group [14].Longevity and Obesity are increasing in Brazil [15,16]. An educational program for patients is only necessary. With this in mind we created an educational program that could be reinforced by telephone calls from the physician team. This is a pilot study to evaluate the improvement in pain, function and quality of life of patients with knee osteoarthritis by means of an educational program and telephone calls. Materials and Methods Trial designRandomized controlled trial. AbstractObjective: To evaluate the improvement in pain, function and quality of life of patients with knee osteoarthritis (OA) by means of an educational program.

Prevalence and Incidence of Hand Osteoarthritis and Upper Limb Complaints in Patients with Knee Osteoarthritis. Correlations among Functionality, Grip Strength, Changes in Body Mass Index and Symptoms among Patients in an Educational Osteoarthritis Program

“…Participants were patients with knee osteoarthritis (KOA) under usual clinical care at the osteometabolic group since 2010. By November 2011, 306 patients were under usual care for KOA and were invitedin 2012 to participate in a multi-professional educational program for the treatment of OA (Orthopedics Institute, Hospital das Clinicas, University of São Paulo) [11]. The patients met the following criteria: outpatient aged 45 years or older with KOA according to the American College of Rheumatology clinical and radiological definition [12]; no rheumatoid arthritis or any other rheumatologic disease other than OA; received usual care for OA during the past six months; knee pain rated above 30 mm on a numerical scale and necessitating drug treatment; no neurological problems; able to understand, agree and sign the informed consent and the questionnaires (irrespective of their level of education); and agree and be evaluated by the occupational therapy team.…”

“…Between March and May (2012), the patients received educational material (booklet and DVD) and/or attended two days of classes with 7 different professional teams (orthopedic surgeons, psychology, physical therapy, occupational therapy, physical fitness, nutritionist and social workers) regarding OA, its causes and modalities of treatment [11]. The importance of diet, exercise and medication was emphasized.…”

“…The sample size included all patients that agreed to participate and were actually evaluated by the occupational therapy group. It is part of a pilot study [11].…”

Schooling of the patients and clinical application of questionnaires in osteoarthitis

“…The records of 102 individuals, patients who were being treated for osteoarthritis in the knees through the PARQVE (Osteoarthritis Project Recovering Quality of Life through Education) program were analysed. 14 Medical records of patients with osteoarthritis according to clinical and radiologic criteria 15 which contained information of interest for this project were included in the study. The information evaluated were age, education (years of schooling), visual analog pain scale (VAS), WOMAC, Lequesne and SF-36 questionnaires, the later including physical (PCS) and mental (MCS) components.…”

Analysis of Anthropometric Measurements and Dietary Intake in Patients Undergoing a Multi-Professional Osteoarthritis Education Program (PARQVE-Project Arthritis Recovering Quality of Life by Means of Education)

“…The program, explained partially in the short-term results [31], comprised two days (from 7:00 to 17:00 hours) of lectures, workshops and meals. The nutritionist's program on the first intervention day was explanatory and emphasized the importance of a small, colorful, frequent (every 3 hours), fiber-rich, low-fat and low glycemic index diet, as well as the importance of drinking at least 2 liters of liquid per day.…”