Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study

Holla, Jasmijn; Leeden, M. van der; Heymans, Martijn W.; Roorda, Leo D.; Bierma-Zeinstra, Sita M A; Boers, Maarten; Lems, Willem F.; Steultjens, Martijn; Dekker, Joost

doi:10.1136/annrheumdis-2012-202984

Cited by 91 publications

(101 citation statements)

References 30 publications

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“…Evidence shows that changes in pain and physical function within the first years of follow-up in patients with hip or knee OA are relatively small and, thus, the potential benefit of the SCS may only be seen after a prolonged period of time. [16][17][18] Also, the results suggest that a relevant difference in change of pain scores cannot be excluded in favour of the patients who received SCS-inconsistent care, as the minimal important change of the WOMAC pain score 19 lies within the 95% CI. Further, self-efficacy and active pain coping hardly changed during the followup period, whereas the self-management booklet was intended to strengthen patient empowerment on these issues.…”

Section: Strengths and Limitationsmentioning

confidence: 90%

Effect of stepped care on health outcomes in patients with osteoarthritis: an observational study in Dutch general practice

Smink¹,

Ende²,

Vlieland

et al. 2014

Br J Gen Pract

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BackgroundA stepped care strategy (SCS) to improve adequate healthcare use in patients with osteoarthritis was developed and implemented in a primary care region in the Netherlands. AimTo assess the association between care that is in line with the SCS recommendations and health outcomes. Design and settingData were used from a 2-year observational study of 313 patients who had consulted their GP because of osteoarthritis. MethodCare was considered 'SCS-consistent' if all advised modalities of the previous steps of the SCS were offered before more advanced modalities of subsequent steps. Pain and physical function were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (range 0-100); active pain coping with the Pain Coping Inventory (range 10-40); and self-efficacy with the Dutch General Self-Efficacy Scale (range 12-48). Crude and adjusted associations between SCS-consistent care and outcomes were estimated with generalised estimating equations. ResultsNo statistically significant differences were found in changes over a 2-year period in pain and physical function between patients who received SCS-inconsistent care (n = 163) and patients who received SCS-consistent care (n = 117). This was also the case after adjusting for possible confounders, that is, -4.3 (95% confidence interval [CI] = -10.3 to 1.7) and -1.9 (95% CI = -7.0 to 3.1), respectively. Furthermore, no differences were found in changes over time between groups in self-efficacy and pain coping. ConclusionThe results raised several important issues that need to be considered regarding the value of the SCS, such as the reasons that GPs provide SCS-inconsistent care, the long-term effects of the SCS, and the effects on costs and side effects.Keywords general practice; osteoarthritis; outcome of care; stepped care strategy.

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Section: Strengths and Limitationsmentioning

confidence: 90%

Effect of stepped care on health outcomes in patients with osteoarthritis: an observational study in Dutch general practice

Smink¹,

Ende²,

Vlieland

et al. 2014

Br J Gen Pract

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“…The number of positive items ranged from 11 27 to 19, 15,16 with a mean of 15 (TA-BLE 3). All studies (n = 16) described the predictors appropriately and measured these with standardized or valid measurements.…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

“…We considered 11 studies to be of sufficient quality. 2,6,15,16,18,19,28,34,39,41,42 None of the studies assessed the internal or external validity of their models.…”

Section: Methodological Quality Assessmentmentioning

confidence: 99%

“…2,6,15,16,21,27,28,30,34,41,42 Seven studies presented the discriminative power by calculating the AUC, which ranged from 0.69 to 0.90. 6,15,16,18,19,39,41 One study discussed the clinical usefulness of the prediction models by calculating the sensitivity, specificity, and likelihood ratios of each predictor (not for the complete model). 10 Three studies used the Hosmer-Lemeshow test for the goodness of fit of their models.…”

Section: Performance Assessmentmentioning

confidence: 99%

“…Most of the studies (n = 10) were conducted in a primary care setting. 6,15,16,18,19,27,30,34,39,41 One study recruited patients from a military population, 10 2 studies from rehabilitation centers, 36,42 and 3 studies were community based. 2,21,28 The sample sizes of the studies varied from 54 to 1021 patients, with a mean sample size of 409.…”

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confidence: 99%

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Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study

Panken¹,

Verhagen²,

Terwee³

et al. 2017

J Orthop Sports Phys Ther

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Longitudinal Course of Physical Function in People With Symptomatic Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative

Øiestad

White

Booton

et al. 2016

Arthritis Care & Research

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Objective Pain and functional decline are hallmarks of knee osteoarthritis (OA). Nevertheless, longitudinal studies unexpectedly reveal stable or improved physical function. The aim of this study was to impute missing and pre–total knee replacement (TKR) values to describe physical function over time among people with symptomatic knee OA. Methods We included participants from the Multicenter Osteoarthritis Study (MOST) and the Osteoarthritis Initiative (OAI) with incident symptomatic knee OA, observed during the first 30 months in MOST and 36 months in OAI. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function (WOMAC-PF), the 5-times sit-to-stand test, and the 20-meter-walk test were assessed at 4 and 5 years in MOST and at 6 years in OAI. We used a multiple imputation method for missing visits, and estimated pre-TKR values close to the time of TKR, using a fitted local regression smoothing curve. In mixed-effect models, we investigated the physical function change over time, using data before and after imputation and calculation of pre-TKR values. Results In MOST, 225 (8%) had incident knee OA, with corresponding 577 (12.7%) in OAI. After adjusting for pre-TKR values and imputing missing values, we found that WOMAC-PF values remained stable or slightly declined over time, and the 20-meter-walk test results changed from stable in nonimputed analyses to worsening using imputed data. Conclusion Data from MOST and OAI showed stable to worsening physical function over time in people with incident symptomatic knee OA after imputing missing values and adjusting pre-TKR values.

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Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study

Cited by 91 publications

References 30 publications

Effect of stepped care on health outcomes in patients with osteoarthritis: an observational study in Dutch general practice

Effect of stepped care on health outcomes in patients with osteoarthritis: an observational study in Dutch general practice

Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study

Longitudinal Course of Physical Function in People With Symptomatic Knee Osteoarthritis: Data From the Multicenter Osteoarthritis Study and the Osteoarthritis Initiative

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