Qualitative Evaluation of Evidence‐Based Online Decision Aid and Resources for Osteoarthritis Management: Understanding Patient Perspectives

Jeon, Yun‐Hee; Flaherty, Ian; Urban, Hema; Wortley, Sally; Dickson, Chris; Salkeld, Glenn; Hunter, David J.

doi:10.1002/acr.23572

Cited by 10 publications

(16 citation statements)

References 33 publications

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“…All of these can impact decision‐making in relation to healthcare needs, disease prevention and health promotion. Having adequate health literacy has been highlighted as a key factor in patients' decisions to adopt and engage with OA self‐management strategies 11 . Health literacy has the potential to influence the appropriateness of self‐care strategies and could therefore impact outcomes achievable via patient‐directed OA management 8,9,50 .…”

Section: Discussionmentioning

confidence: 99%

“…Adequate health literacy has previously been shown to be integral to patients' decisions to adopt and engage with OA self‐management strategies 11 . However, data exploring this issue from the perspective of the patient are limited 11,17 .…”

Section: Introductionmentioning

confidence: 99%

“…1 Health literacy has been highlighted as an important component of patient engagement self-management strategies. [8][9][10][11] There are negative relationships between health literacy and diagnosis comprehension, 12,13 health outcomes 14 and use of healthcare services, 15 and limited health literacy is identified as an obstacle to accessing primary care services. 16 Adequate health literacy has previously been shown to be integral to patients' decisions to adopt and engage with OA selfmanagement strategies.…”

Section: Introductionmentioning

confidence: 99%

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Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey

McLachlan

Carroll

Hunter

et al. 2022

Health Expectations

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Background: Guidelines encourage engagement in self-care activities for osteoarthritis (OA), but there are gaps in consumers' knowledge about suitable choices for self-care. Community pharmacists are in an ideal position to contribute to OA management through screening and supporting evidence-based pain management choices. Prior research established an association between health literacy and advice-seeking and appropriateness of analgesics choices (both lower in participants with limited health literacy) amongst people living with OA. This article explores the implications of these data for pharmacists in OA management.Methods: A national online survey was conducted amongst 628 adults aged 45-74 years, currently residing in Australia, with self-reported symptoms of OA. All data were collected using a customized online questionnaire, which was completed only once. 'Self-reported symptoms of OA' was based on six validated screening questions to identify people with OA without a formal clinical diagnosis.Results: Respondents matched the typical profile of people diagnosed with OA; more than half were female (56%), knees (59%) and hips (31%) were the primary affected joints and 74% were either overweight or obese. Self-identification of OA was limited (41%). Overall, 38% self-managed their pain, and limited health literacy was associated with less advice-seeking. Efficacy and ease of use were the main reasons cited for prompting use across all classes of nonprescription analgesic, with

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey

McLachlan

Carroll

Hunter

et al. 2022

Health Expectations

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“…Further modifications and improvements are currently being guided by additional qualitative research with consumers and physiotherapists and by using tools such as Health on the Net Foundation Code and DISCERN. Low computer and health literacy have been reported as barriers to improvement following other web-based interventions for chronic musculoskeletal conditions [ 48 , 49 ]. Our findings may not be applicable for people with low computer literacy skills.…”

Section: Discussionmentioning

confidence: 99%

Novel Stepped Care Approach to Provide Education and Exercise Therapy for Patellofemoral Pain: Feasibility Study

Silva¹,

Pazzinatto²,

Crossley³

et al. 2020

J Med Internet Res

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Background Patellofemoral pain (PFP) impairs joint- and health-related quality of life and may be associated with knee osteoarthritis. We developed a novel, 2-phase, stepped-care approach for PFP, combining (1) self-directed web-based education and exercise therapy with (2) physiotherapist-supported education and exercise therapy. Physiotherapy sessions can be provided using 2 different modalities: face-to-face and telerehabilitation. Objective This study aims to (1) determine the feasibility of our stepped-care approach, (2) explore patient-reported outcomes following self-directed web-based education and exercise therapy in people with PFP (phase 1), and (3) estimate the differences in treatment effects between face-to-face and telerehabilitation to support further education and exercise therapy (phase 2) in those who had not completely recovered following self-directed care. Methods Phase 1 involved 6 weeks of self-directed web-based education and exercise therapy. Phase 2 involved random allocation to a further 12 weeks of physiotherapist-led (up to 8 sessions) education and exercise therapy delivered face-to-face or via telerehabilitation to participants who did not rate themselves as completely recovered following phase 1. Feasibility indicators of process, adherence, and participant retention were collected as primary outcomes alongside patient-reported outcomes on Global Rating of Change and knee pain, disability, knee-related quality of life, pain catastrophism, kinesiophobia, and knee self-efficacy. All participants were assessed at baseline, 6 weeks, and 18 weeks. Results A total of 71 participants were screened to identify 35 participants with PFP to enter the study. Overall, 100% (35/35) and 88% (31/35) of the participants were followed up with at 6 and 18 weeks, respectively. In phase 1 of the study, participants accessed the My Knee Cap website for an average of 6 (7.5) days and performed the exercises for an average of 2.5 (3.6) times per week. A total of 20% (7/35) of the participants reported that they had completely recovered at 6 weeks. Furthermore, 93% (26/28) of the participants who were followed up and had not completely recovered at 6 weeks agreed to be enrolled in phase 2. No statistically significant differences were found between the face-to-face and telerehabilitation groups for any outcome. The novel stepped-care approach was associated with marked improvement or complete recovery in 40% (14/35) of the participants following phase 1 and 71% (25/35) of the participants following phase 2. Conclusions Self-directed web-based education and exercise therapy for people with PFP is feasible, as noted by the high rate of participant retention and home exercise adherence achieved in this study. Furthermore, 20% (7/35) of people reported complete recovery at 6 weeks. Both face-to-face and telerehabilitation physiotherapy should be considered for those continuing to seek care, as there is no difference in outcomes between these delivery modes. Determining the efficacy of the stepped-care model may help guide more efficient health care for PFP.

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“…People with LBP consistently report a desire for trustworthy information about their condition11–14 and the internet, with its capacity to provide tailored information in varied formats at a time and place of the user’s choosing, is ideal to provide such information. Positive features of internet use include the potential for patients to become better informed about their condition and potential treatment options,15–18 to become more engaged with their treatment19 and to improve health outcomes with more appropriate use of health resources 18 20 21. Access and reflection on information prior to clinical visits could also ensure efficient use of clinical consultation time,15 20 enhance relationships between patients and clinicians18 and foster informed decision-making 20…”

Section: Introductionmentioning

confidence: 99%

MyBackPain—evaluation of an innovative consumer-focused website for low back pain: study protocol for a randomised controlled trial

et al. 2019

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IntroductionDespite the prevalence of low back pain (LBP) worldwide, many people with the condition do not receive evidence-based care or achieve the best possible outcomes. There is a gap in the dissemination of evidence-based information across the globe. The advent of the internet has changed the way people obtain health information. As such, trustworthy, tailored and validated LBP resources may help bridge the gap. This study aims to measure the effectiveness of a new website (MyBackPain) in improving spinal health literacy, treatment preferences and clinical outcomes for people with LBP, in comparison with other online resources.Methods and analysisThis online, pragmatic, randomised controlled trial will comprise 440 people with non-specific LBP of any duration. In addition to access to publicly available online information (control group), the intervention group will be given access to the MyBackPain.org.au website. Participants and research staff, including the biostatistician, will be blinded to treatment allocation. Data will be collected at baseline, 1, 3 (primary end-point), 6 and 12 months via online surveys and questionnaires. The primary outcome is spinal health literacy. Secondary outcomes include quality of treatment preferences (stated and observed) and LBP clinical outcomes (pain, disability and quality of life). Analyses will be by intention-to-treat and include outcome data on all randomised participants. Descriptive statistics will be presented for demographic and clinical characteristics.Ethics and disseminationThis trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry and has ethical approval from the University of Queensland Human Research Ethics Committee (2017000995). Trial outcomes will be shared via national and international conference presentations and peer-reviewed journal publications.Trial registration numberACTRN12617001292369; Pre-results.

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Qualitative Evaluation of Evidence‐Based Online Decision Aid and Resources for Osteoarthritis Management: Understanding Patient Perspectives

Cited by 10 publications

References 33 publications

Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey

Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey

Novel Stepped Care Approach to Provide Education and Exercise Therapy for Patellofemoral Pain: Feasibility Study

MyBackPain—evaluation of an innovative consumer-focused website for low back pain: study protocol for a randomised controlled trial

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