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Within-person change in patient-reported outcomes and their association with the wish to undergo joint surgery during a digital first-line intervention for osteoarthritis

Dell'Isola, Andrea LU ; Nero, Håkan LU ; Dahlberg, Leif E LU ; Ignjatovic, Majda Misini LU ; Lohmander, L Stefan LU orcid ; Cronström, Anna LU and Kiadaliri, Ali LU orcid (2023) In Osteoarthritis and Cartilage 31(9). p.1257-1264
Abstract

AIM: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA).

METHODS: Retrospective observational registry study. Participants enrolled between 01/06/2018 and 30/10/2021 with follow-up data at 3 months (n=13,961). We used asymmetric fixed effect (conditional) logistic regressions to study the association between change in wish to undergo surgery at last available time point (3,6,9 or 12 months) and improvement or worsening of PROMs pain (0-10), quality of life (EQ5D-5L, 0.243-0.976), overall health (0-10), activity impairment (0-10), walking... (More)

AIM: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA).

METHODS: Retrospective observational registry study. Participants enrolled between 01/06/2018 and 30/10/2021 with follow-up data at 3 months (n=13,961). We used asymmetric fixed effect (conditional) logistic regressions to study the association between change in wish to undergo surgery at last available time point (3,6,9 or 12 months) and improvement or worsening of PROMs pain (0-10), quality of life (EQ5D-5L, 0.243-0.976), overall health (0-10), activity impairment (0-10), walking difficulties (yes/no), fear of movement (yes/no) and Knee/Hip injury and Osteoarthritis Outcome Score 12 Items (KOOS-12/HOOS-12, 0-100) function and quality of life (QoL) subscales.

RESULTS: The proportion of participants wishing to undergo surgery declined by 2% (95% CI 1.9, 3.0), from 15.7% at the baseline to 13.3% at 3 months. Generally, improvements in PROMs were associated with reduced likelihood of wishing for surgery while worsening was associated with increased likelihood. For pain, activity impairment EQ-5D and KOOS/HOOS QoL, a worsening led to a change in the probability of wish for surgery of larger absolute magnitude than an improvement in the same PROM.

CONCLUSIONS: Within-person improvements in PROMs are associated with reduced wish for surgery, while worsenings with an increased wish for surgery. Larger improvements in PROMs may be needed to match the magnitude of the change in wish for surgery associated with a worsening in the same PROM.

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author
; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Osteoarthritis and Cartilage
volume
31
issue
9
pages
1257 - 1264
publisher
Elsevier
external identifiers
  • scopus:85163294236
  • pmid:37268286
ISSN
1063-4584
DOI
10.1016/j.joca.2023.05.011
project
Digital education and physical therapy for people with musculoskeletal pain
language
English
LU publication?
yes
additional info
Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.
id
3d260e29-7f5d-43d1-b3d6-9d5caa10650a
date added to LUP
2023-06-03 23:17:21
date last changed
2024-04-19 22:35:19
@article{3d260e29-7f5d-43d1-b3d6-9d5caa10650a,
  abstract     = {{<p>AIM: To study the association between within-person changes in patient-reported outcomes (PROMs) and wish for joint surgery during participation in a digital first-line intervention comprising exercise and education for knee/hip osteoarthritis (OA).</p><p>METHODS: Retrospective observational registry study. Participants enrolled between 01/06/2018 and 30/10/2021 with follow-up data at 3 months (n=13,961). We used asymmetric fixed effect (conditional) logistic regressions to study the association between change in wish to undergo surgery at last available time point (3,6,9 or 12 months) and improvement or worsening of PROMs pain (0-10), quality of life (EQ5D-5L, 0.243-0.976), overall health (0-10), activity impairment (0-10), walking difficulties (yes/no), fear of movement (yes/no) and Knee/Hip injury and Osteoarthritis Outcome Score 12 Items (KOOS-12/HOOS-12, 0-100) function and quality of life (QoL) subscales.</p><p>RESULTS: The proportion of participants wishing to undergo surgery declined by 2% (95% CI 1.9, 3.0), from 15.7% at the baseline to 13.3% at 3 months. Generally, improvements in PROMs were associated with reduced likelihood of wishing for surgery while worsening was associated with increased likelihood. For pain, activity impairment EQ-5D and KOOS/HOOS QoL, a worsening led to a change in the probability of wish for surgery of larger absolute magnitude than an improvement in the same PROM.</p><p>CONCLUSIONS: Within-person improvements in PROMs are associated with reduced wish for surgery, while worsenings with an increased wish for surgery. Larger improvements in PROMs may be needed to match the magnitude of the change in wish for surgery associated with a worsening in the same PROM.</p>}},
  author       = {{Dell'Isola, Andrea and Nero, Håkan and Dahlberg, Leif E and Ignjatovic, Majda Misini and Lohmander, L Stefan and Cronström, Anna and Kiadaliri, Ali}},
  issn         = {{1063-4584}},
  language     = {{eng}},
  month        = {{05}},
  number       = {{9}},
  pages        = {{1257--1264}},
  publisher    = {{Elsevier}},
  series       = {{Osteoarthritis and Cartilage}},
  title        = {{Within-person change in patient-reported outcomes and their association with the wish to undergo joint surgery during a digital first-line intervention for osteoarthritis}},
  url          = {{http://dx.doi.org/10.1016/j.joca.2023.05.011}},
  doi          = {{10.1016/j.joca.2023.05.011}},
  volume       = {{31}},
  year         = {{2023}},
}