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Does clinical presentation predict response to a nonsurgical chronic disease management program for endstage hip and
Jillian P Eyles1, Barbara R Lucas1, Jillian A Patterson1
1From the Physiotherapy Department and Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School; Kolling Institute of Medical Research; Institute of Bone and Joint Research; University of Sydney, Sydney; Physiotherapy Department, Wollongong Hospital, Wollongong, New South Wales, Australia.J.P. Eyles, BAppSc(Phty); B.R. Lucas, MPH, FACP, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; J.A. Patterson, BScAdv(Hons), MBiostat, Kolling Institute of Medical Research; M.J. Williams, BAppSc(Phty), Physiotherapy Department, Royal North Shore Hospital; K. Weeks, BAppSc(Phty), Physiotherapy Department, Wollongong Hospital; M. Fransen, PhD, MPH, University of Sydney; D.J. Hunter, MBBS, PhD, FRACP, Department of Rheumatology, Royal North Shore Hospital; Northern Clinical School, Kolling Institute of Medical Research, Institute of Bone and Joint Research, University of Sydney.
Objective:
To identify baseline characteristics of participants who will respond favorably following 6 months of participation in a chronic disease management program for hip and knee osteoarthritis (OA).
Methods:
This prospective cohort study assessed 559 participants at baseline and following 6 months of participation in the Osteoarthritis Chronic Care Program. Response was defined as the minimal clinically important difference of an 18% and 9-point absolute improvement in the Western Ontario and McMaster Universities Arthritis Index global score. Multivariate logistic regression modeling was used to identify predictors of response.
Results:
Complete data were available for 308 participants. Those who withdrew within the study period were imputed as nonresponders. Three variables were independently associated with response: signal joint (knee vs hip), sex, and high level of comorbidity. Index joint and sex were significant in the multivariate model, but the model was not a sensitive predictor of response.
Conclusion:
Strong predictors of response to a chronic disease management program for hip and knee OA were not identified. The significant predictors that were found should be considered in future studies.
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