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
(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
- Dell'Isola, Andrea LU ; Nero, Håkan LU ; Dahlberg, Leif E LU ; Ignjatovic, Majda Misini LU ; Lohmander, L Stefan LU ; Cronström, Anna LU and Kiadaliri, Ali LU
- organization
-
- LU Profile Area: Proactive Ageing
- Orthopaedics (Lund)
- Lund OsteoArthritis Division - From molecule to clinical implementation (research group)
- EpiHealth: Epidemiology for Health
- Lund OsteoArthritis Division - Molecular marker research group (research group)
- Sport Sciences (research group)
- Lund OsteoArthritis Division - Clinical Epidemiology Unit (research group)
- publishing date
- 2023-05-31
- 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}}, }