Self-Management of Osteoarthritis

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

523 participants

Study Classification

INTERVENTIONAL

Study Start Date

2006-10-31

Study Completion Date

2009-09-30

Brief Summary

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The purpose of this study is to examine whether a telephone-based self-management intervention improves pain, physical function, and other outcomes among veterans with osteoarthritis of the hip or knee.

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Detailed Description

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Background / Rationale: Osteoarthritis (OA) is the one of the most common chronic conditions among veterans, and over half of VA health care users with OA report being limited in their daily activities because of joint symptoms. However, studies have not examined interventions to improve outcomes or quality of care among the large and growing number of veterans with OA. Telephone-based self-management interventions may be a cost-effective way to improve pain, physical function, and other outcomes in this patient population. Objective: The purpose of this study is to examine the effectiveness of a one-year telephone-based self-management intervention for veterans with hip or knee OA. The primary hypothesis is that the self-management intervention will result in a greater reduction in pain as compared to both usual care and attention control conditions. Methods: This will be a randomized control trial of 519 veterans at the Durham VAMC who have radiographic evidence and a physician diagnosis of OA of the hip or knee. Participants will be equally allocated to self-management, attention control, and usual care groups. The self-management intervention is designed to provide participants with key information about OA and its treatment and to enhance participants' self-efficacy for managing OA-related symptoms. This intervention will involve provision of written, audio, and video educational materials, as well as monthly telephone calls by a nurse. The nurse will guide participants in developing personal OA-related goals, as well as specific plans for meeting these goals. Other strategies for enhancing self-efficacy will include modeling and mastery of self-management behaviors, persuasion to adopt these behaviors, and reinterpretation of OA symptoms. The attention control group will receive written materials on health screening related topics (not OA-related), and the nurse will call participants on a monthly basis to discuss these materials. The primary outcome measure for this study will be self-reported pain (Arthritis Impact Measurement-2 (AIMS2) subscale), and secondary outcomes will be self-reported function (AIMS2 subscale), affect (AIMS2 subscale), and arthritis specific self-efficacy. Outcomes will be measured at baseline and following the one-year study period. Analysis of covariance will be used to compare primary and secondary outcomes between the intervention group and each of the control groups, adjusting for baseline measures, participant demographic and clinical characteristics. We will also examine the cost-effectiveness of the intervention. Impact: This study is significant because it examines a highly prevalent but understudied chronic illness among veterans. In addition, this OA self-management program will contribute to the VA health care system's specific mission to improve pain management through patient education and participation. The proposed self-management intervention will be low-cost and easy to disseminate within the VA health care system. Therefore it may be an important tool for improving outcomes, especially pain, among many veterans with OA.

Conditions

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Osteoarthritis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

SINGLE_GROUP

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Health Education Intervention

Group Type ACTIVE_COMPARATOR

Health Education

Intervention Type BEHAVIORAL

12-month intervention consisting of monthly phone calls about common health conditions and screening. Also includes written educational materials on these topics.

Usual Medical Care

Group Type NO_INTERVENTION

No interventions assigned to this group

Osteoarthritis Self-Management

Group Type EXPERIMENTAL

Osteoarthritis Self-Management

Intervention Type BEHAVIORAL

12-month intervention consisting of monthly phone calls about topics related to self-care for osteoarthritis. Also includes written educational materials on these topics. Participants set goals and action plans, with assistance from health educator, about managing their osteoarthritis.

Interventions

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Health Education

12-month intervention consisting of monthly phone calls about common health conditions and screening. Also includes written educational materials on these topics.

Intervention Type BEHAVIORAL

Osteoarthritis Self-Management

12-month intervention consisting of monthly phone calls about topics related to self-care for osteoarthritis. Also includes written educational materials on these topics. Participants set goals and action plans, with assistance from health educator, about managing their osteoarthritis.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Radiographic evidence of hip or knee osteoarthritis
* Current / persistent joint symptoms (pain, aching, stiffness)

Exclusion Criteria

* Other rheumatic disease (i.e., rheumatoid arthritis, fibromyalgia)
* Hospitalization for stroke or cardiovascular event within past 3 months
* Metastatic cancer
* Active diagnosis of psychosis
* Terminal illness
* On waiting list for arthroplasty
* Resident of nursing home
* Severely impaired in hearing or speech (participants must be able to respond to phone calls)
* Significant cognitive dysfunction
* No access to a telephone
* Current participation in another interventional study for osteoarthritis

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes