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ACTIVE LIVING WITH OSTEOARTHRITIS - IMPLEMENTATION OF EVIDENCE-BASED GUIDELINES AS FIRST-LINE TREATMENT FOR PATIENTS WITH KNEE AND HIP OSTEOARTHRITIS
ESSKA Academy. Risberg M. May 11, 2018; 218119
May Arna Risberg
May Arna Risberg
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Abstract
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Objectives: Objectives: Implementation of international guidelines for treatment of patients with mild to moderate knee and hip osteoarthritis (OA) has so far been inadequate. The Active living with OsteoArthritis (ActiveOA) was launched in 2015 with the aim of implementing guidelines for treatment of patients with mild to moderate knee and/or hip OA in clinical care nationwide. The purpose of this study was to report the first data from the quality registry from 2015-2017.

Methods: Methods: The ActiveOA model consists of three parts: 1) a structured educational program for physiotherapists, 2) an evidence-based educational and exercise program for patients with knee and/or hip OA, and 3) an electronic quality register (prospectively collected) including data on: age, gender, education, smoking, weight and height, target joint, work disability, medication, pain (NRS), physical activity level, patient specific functional scale (PSFS), 6-minute walk test, 30 seconds sit to stand test, stairs-climbing test. HOOS/KOOS subscales: Sport/Rec and Quality of Life, health-related quality of life (EQ5D), self-efficacy for pain (ASES), global rating of change in pain and function, and user satisfaction with the program.

Results: Results: The ActiveOA program is offered in all five health regions in Norway, 13 courses have been arranged including 746 physiotherapists nationwide. By August 2017, data from 2518 participants were analyzed. There were 76 % women. The mean age was 63.5 (± 9.8) years, the BMI was 27.9 (± 4.8), and 65% reported knee OA and 32% reported hip OA as their target joint. Sixty-three percent were still in part time or full time jobs at inclusion, 26.5% had been on sick leave. Seventy-seven percent and 52 % of the participants answered all questionnaires at 3 months and 1 year, respectively.
Pain measured decreased from 5.0 (± 1.9) to 4.4 (± 2.0) (p <0.001) after 3 months and 4.3 (± 2.1) after 1 year. Seventy-two percent reported improvement in function, 21% was unchanged and 7% had worse function after 3 months. They reported an improvement in their overall health (EQ5D), from 63.2 (± 0.5) at inclusion to 64.8 (± 0.5) (p = 0.006) and 64.8 (± 0.9) after 3 and 12 months, respectively. There was a significant improvement in functional performance for all 3 functional tests after 3 months. After 12 months, 86.4% of participants indicated that they used their ActiveOA program at least once a week.

Conclusions: Conclusions: Less than two years after its inception the ActiveOA program has been implemented nationwide. The first data on more than 2500 participants showed a significant reduction in pain and improvement in function and overall quality of life after 3 months, and the change is maintained after 12 months. ActiveOA proves to be useful for patients, and is a good option when GPs and orthopedic surgeons refer patients to non-surgical treatment. More efforts need to be carried out for higher compliance rates at long-term follow-ups.

Keywords:
knee, hip, osteoarthritis, implementation, quality registry
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