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Digital self-management, analgesic use and patient-reported outcomes in knee or hip osteoarthritis

Mahmoudian, Armaghan LU ; Lohmander, L Stefan LU orcid ; Dahlberg, Leif e LU and Kiadaliri, Ali LU orcid (2024) In Archives of Physical Medicine and Rehabilitation
Abstract
Objective
To investigate changes in analgesic use before and after participation in a digital first-line treatment program (exercise and patient education) in persons with knee or hip OA and to explore associations between these changes in medication use and participant-reported pain and function.

Design
Retrospective cohort study with pre-post measures.

Setting
Community setting, Sweden.

Participants
Individuals (n=4100, mean [SD] age 64.5 [9.3], 73.3% females) participating in the digital program.

Interventions
A digital supervised education and exercise therapy.

Main Outcome Measures
Self-reported analgesic use for knee/hip pain during the past month at baseline and... (More)
Objective
To investigate changes in analgesic use before and after participation in a digital first-line treatment program (exercise and patient education) in persons with knee or hip OA and to explore associations between these changes in medication use and participant-reported pain and function.

Design
Retrospective cohort study with pre-post measures.

Setting
Community setting, Sweden.

Participants
Individuals (n=4100, mean [SD] age 64.5 [9.3], 73.3% females) participating in the digital program.

Interventions
A digital supervised education and exercise therapy.

Main Outcome Measures
Self-reported analgesic use for knee/hip pain during the past month at baseline and 12-week follow-up, knee/hip NRS pain (0-10, a higher value indicating more pain), and KOOS-12 or HOOS-12 Function subscale (0-100, higher values indicating better function). McNemar test, multivariable logistic regression and linear random intercept model were used for statistical analyses.

Results
Among participants, 61.4% and 49.4% were analgesic users at baseline and 12-week follow up, respectively, (absolute reduction 12.0%, 95%CI 10.5, 13.5). Being female, having hip OA, lower education, higher body mass index, living outside large metropolitan cities, co-existing rheumatoid arthritis, and walking difficulties were associated with higher odds of analgesic use at baseline. At both time points, persons not using analgesics at the time reported better outcomes. All groups but “new users” experienced improvements in their pain and function following participation in digital program with the greatest improvements observed among “quitters”.

Conclusion
Engaging in a digital exercise and patient education program as a primary treatment for knee or hip osteoarthritis was associated with a reduction in the use of analgesics. The greatest improvements were seen for those who stopped analgesic use. These results highlight the importance of providing effective first-line treatment to people with knee or hip OA. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Archives of Physical Medicine and Rehabilitation
publisher
Elsevier
ISSN
0003-9993
DOI
10.1016/j.apmr.2024.05.033
language
English
LU publication?
yes
id
1ae89800-a27c-4f61-96a8-f4fd29371365
date added to LUP
2024-06-12 15:14:25
date last changed
2024-06-12 16:42:00
@article{1ae89800-a27c-4f61-96a8-f4fd29371365,
  abstract     = {{Objective<br/>To investigate changes in analgesic use before and after participation in a digital first-line treatment program (exercise and patient education) in persons with knee or hip OA and to explore associations between these changes in medication use and participant-reported pain and function.<br/><br/>Design<br/>Retrospective cohort study with pre-post measures.<br/><br/>Setting<br/>Community setting, Sweden.<br/><br/>Participants<br/>Individuals (n=4100, mean [SD] age 64.5 [9.3], 73.3% females) participating in the digital program.<br/><br/>Interventions<br/>A digital supervised education and exercise therapy.<br/><br/>Main Outcome Measures<br/>Self-reported analgesic use for knee/hip pain during the past month at baseline and 12-week follow-up, knee/hip NRS pain (0-10, a higher value indicating more pain), and KOOS-12 or HOOS-12 Function subscale (0-100, higher values indicating better function). McNemar test, multivariable logistic regression and linear random intercept model were used for statistical analyses.<br/><br/>Results<br/>Among participants, 61.4% and 49.4% were analgesic users at baseline and 12-week follow up, respectively, (absolute reduction 12.0%, 95%CI 10.5, 13.5). Being female, having hip OA, lower education, higher body mass index, living outside large metropolitan cities, co-existing rheumatoid arthritis, and walking difficulties were associated with higher odds of analgesic use at baseline. At both time points, persons not using analgesics at the time reported better outcomes. All groups but “new users” experienced improvements in their pain and function following participation in digital program with the greatest improvements observed among “quitters”.<br/><br/>Conclusion<br/>Engaging in a digital exercise and patient education program as a primary treatment for knee or hip osteoarthritis was associated with a reduction in the use of analgesics. The greatest improvements were seen for those who stopped analgesic use. These results highlight the importance of providing effective first-line treatment to people with knee or hip OA.}},
  author       = {{Mahmoudian, Armaghan and Lohmander, L Stefan and Dahlberg, Leif e and Kiadaliri, Ali}},
  issn         = {{0003-9993}},
  language     = {{eng}},
  month        = {{06}},
  publisher    = {{Elsevier}},
  series       = {{Archives of Physical Medicine and Rehabilitation}},
  title        = {{Digital self-management, analgesic use and patient-reported outcomes in knee or hip osteoarthritis}},
  url          = {{http://dx.doi.org/10.1016/j.apmr.2024.05.033}},
  doi          = {{10.1016/j.apmr.2024.05.033}},
  year         = {{2024}},
}