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Proportion of acceptable symptom state nearly tripled with improvements in patient-reported outcomes for all symptom state subgroups : A registry study of over 15,000 osteoarthritis patients in a digital education and exercise therapy

Kiadaliri, Ali LU orcid ; Lohmander, L Stefan LU orcid ; Nelson, Amanda E and Dahlberg, Leif E LU (2025) In Arthritis Care and Research
Abstract

OBJECTIVE: This study investigated trajectories of patient acceptable symptom state (PASS) among participants of a digital education and exercise therapy for knee and hip osteoarthritis.

METHODS: A longitudinal observational study among individuals aged 40+ years who participated in the digital program. Participants completed PASS (yes/no) at enrolment and at least one follow-up during one year after enrolment (n=15,253). Group-based trajectory modelling was used to identify groups with distinct PASS trajectories. We used multinomial logistic regression and linear random intercept models to explore predictors and compare changes in patient-reported outcome measures (PROMs) across trajectory subgroups.

RESULTS: The proportion... (More)

OBJECTIVE: This study investigated trajectories of patient acceptable symptom state (PASS) among participants of a digital education and exercise therapy for knee and hip osteoarthritis.

METHODS: A longitudinal observational study among individuals aged 40+ years who participated in the digital program. Participants completed PASS (yes/no) at enrolment and at least one follow-up during one year after enrolment (n=15,253). Group-based trajectory modelling was used to identify groups with distinct PASS trajectories. We used multinomial logistic regression and linear random intercept models to explore predictors and compare changes in patient-reported outcome measures (PROMs) across trajectory subgroups.

RESULTS: The proportion of participants reporting acceptable symptom state rose from 17.4% (95%CI 16.8, 18.1) at enrolment to 42.4% (41.6, 43.1) and 48.9% (47.5, 50.2) at 3- and 12-month follow-ups, respectively. We identified four PASS trajectories: 1) "persistently not achieving PASS (PNAP)" (45.1%), 2) "early sustained PASS (ESP)" (34.8%), 3) "gradually increasing satisfaction (GIS)" (10.8%) and 4) "early PASS, later unacceptable PASS (EPLUP)" (9.3%). Among baseline variables, female sex, older age, non-metropolitan residence, lower education, knee OA, fear of movement, no walking difficulties, no wish for surgery and better PROMs were generally associated with higher odds of following trajectories other than the "PNAP". All trajectories experienced improvements in PROMs, with generally larger improvements in the ESP and GIS groups than the other two groups.

CONCLUSIONS: The percentage of participants achieving PASS almost tripled at 12 months. Improvements in PROMs across all PASS trajectories highlights the importance of distinction between "feeling better" and "feeling good".

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author
; ; and
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type
Contribution to journal
publication status
epub
subject
in
Arthritis Care and Research
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:40598777
ISSN
2151-4658
DOI
10.1002/acr.25594
language
English
LU publication?
yes
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This article is protected by copyright. All rights reserved.
id
b2996c09-0113-4a84-8a2f-bbb0c0ca3af9
date added to LUP
2025-07-03 10:02:54
date last changed
2025-07-03 11:40:26
@article{b2996c09-0113-4a84-8a2f-bbb0c0ca3af9,
  abstract     = {{<p>OBJECTIVE: This study investigated trajectories of patient acceptable symptom state (PASS) among participants of a digital education and exercise therapy for knee and hip osteoarthritis.</p><p>METHODS: A longitudinal observational study among individuals aged 40+ years who participated in the digital program. Participants completed PASS (yes/no) at enrolment and at least one follow-up during one year after enrolment (n=15,253). Group-based trajectory modelling was used to identify groups with distinct PASS trajectories. We used multinomial logistic regression and linear random intercept models to explore predictors and compare changes in patient-reported outcome measures (PROMs) across trajectory subgroups.</p><p>RESULTS: The proportion of participants reporting acceptable symptom state rose from 17.4% (95%CI 16.8, 18.1) at enrolment to 42.4% (41.6, 43.1) and 48.9% (47.5, 50.2) at 3- and 12-month follow-ups, respectively. We identified four PASS trajectories: 1) "persistently not achieving PASS (PNAP)" (45.1%), 2) "early sustained PASS (ESP)" (34.8%), 3) "gradually increasing satisfaction (GIS)" (10.8%) and 4) "early PASS, later unacceptable PASS (EPLUP)" (9.3%). Among baseline variables, female sex, older age, non-metropolitan residence, lower education, knee OA, fear of movement, no walking difficulties, no wish for surgery and better PROMs were generally associated with higher odds of following trajectories other than the "PNAP". All trajectories experienced improvements in PROMs, with generally larger improvements in the ESP and GIS groups than the other two groups.</p><p>CONCLUSIONS: The percentage of participants achieving PASS almost tripled at 12 months. Improvements in PROMs across all PASS trajectories highlights the importance of distinction between "feeling better" and "feeling good".</p>}},
  author       = {{Kiadaliri, Ali and Lohmander, L Stefan and Nelson, Amanda E and Dahlberg, Leif E}},
  issn         = {{2151-4658}},
  language     = {{eng}},
  month        = {{07}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Arthritis Care and Research}},
  title        = {{Proportion of acceptable symptom state nearly tripled with improvements in patient-reported outcomes for all symptom state subgroups : A registry study of over 15,000 osteoarthritis patients in a digital education and exercise therapy}},
  url          = {{http://dx.doi.org/10.1002/acr.25594}},
  doi          = {{10.1002/acr.25594}},
  year         = {{2025}},
}