Feasibility and efficacy of a multidisciplinary health care programme for patients with knee osteoarthritis

To examine the feasibility and efficacy of a multidisciplinary health care programme for patients with knee OA.

A 12-month follow-up care programme for knee OA, based on clinical evidence and expert opinion was implemented in primary care settings. It included recommendations on diagnosis, management and follow-up. Consecutive patients with knee OA and pain were included, classified into mild (21-39 score), moderate (40-69 score), severe disease (70-100 score) in WOMAC pain subscale, and managed according to the programme. Data were recorded using electronic devices or internet at each visit. Primary end points were: OMERACT-OARSI responder criteria; 70% compliance rate of the recommendations.

We included 226 patients, 75% women, mean age 63 years, mean disease duration of 2.4 years, 76% reported Kellgren-Lawrence grade 3-4, and were classified as mild: 17%, moderate: 54% and severe disease: 29%. At the end of the study, 78% of patients achieved pain relief of ≥ 20 points in the WOMAC pain subscale, and 80% OMERACT-OARSI response criteria. Almost 90% of physicians followed the recommendations. WOMAC and SF-36 subscales/dimensions improved (p<0.050), 14% remained classified as moderate or severe disease, 85% of patients attended the exercise training course, and more than 80% of patients and professionals were satisfied with the programme. Compared to usual care the programme seems to use fewer resources.

The implementation of multidisciplinary health care programmes could be very effective and viable for the management of knee OA, could increase patients' and health professional's satisfaction, and optimise health care resources use.