Table IV.
Effectiveness of the model osteoarthritis consultation compared to usual primary care for osteoarthritis: evaluation of secondary outcomes
| Outcome | Intervention |
Control |
∗Mean difference (95% CI) | †Effect size (95% CI) | P-value | ||||
|---|---|---|---|---|---|---|---|---|---|
| Valid n | Mean | SD | Valid n | Mean | SD | ||||
| Pain intensity scores | |||||||||
| Hip | |||||||||
| Post-consultation | 274 | 3.52 | 3.47 | 234 | 3.38 | 3.34 | – | – | – |
| 3 months | 241 | 2.98 | 3.16 | 190 | 3.04 | 3.28 | −0.19 (−0.63, 0.26) | −0.06 (−0.18, 0.08) | 0.415 |
| 6 months | 212 | 2.59 | 3.09 | 172 | 2.78 | 3.17 | −0.24 (−0.78, 0.30) | −0.07 (−0.23, 0.09) | 0.382 |
| 12 months | 187 | 2.79 | 3.13 | 155 | 2.71 | 2.97 | −0.15 (−0.90, 0.59) | −0.04 (−0.26, 0.17) | 0.687 |
| Knee | |||||||||
| Post-consultation | 278 | 5.67 | 3.09 | 230 | 5.63 | 3.28 | – | – | – |
| 3 months | 247 | 4.64 | 3.11 | 195 | 4.69 | 3.14 | −0.49 (−0.94, −0.05) | −0.15 (−0.30, −0.02) | 0.031 |
| 6 months | 215 | 4.27 | 3.01 | 173 | 4.68 | 3.17 | −0.20 (−0.74, 0.34) | −0.06 (−0.23, 0.11) | 0.468 |
| 12 months | 190 | 4.25 | 3.32 | 159 | 3.89 | 3.08 | 0.04 (−0.71, 0.80) | 0.01 (−0.22, 0.25) | 0.909 |
| Hand | |||||||||
| Post-consultation | 273 | 2.94 | 3.11 | 230 | 2.99 | 3.22 | – | – | – |
| 3 months | 245 | 2.62 | 2.83 | 194 | 2.61 | 2.86 | −0.15 (−0.56, 0.25) | −0.05 (−0.18, 0.08) | 0.458 |
| 6 months | 213 | 2.57 | 2.78 | 170 | 2.89 | 3.02 | −0.09 (−0.57, 0.38) | −0.03 (−0.18, 0.12) | 0.697 |
| 12 months | 189 | 2.80 | 2.86 | 157 | 2.91 | 3.02 | −0.40 (−1.04, 0.24) | −0.13 (−0.33, 0.08) | 0.218 |
| Foot | |||||||||
| Post-consultation | 275 | 2.79 | 3.12 | 231 | 2.97 | 3.34 | – | – | – |
| 3 months | 245 | 2.36 | 2.85 | 192 | 2.44 | 3.04 | 0.03 (−0.41, 0.47) | 0.01 (−0.13, 0.15) | 0.904 |
| 6 months | 209 | 2.43 | 2.92 | 170 | 2.46 | 3.08 | 0.30 (−0.23, 0.83) | 0.09 (−0.07, 0.26) | 0.272 |
| 12 months | 189 | 2.48 | 3.05 | 157 | 2.45 | 3.14 | 0.27 (−0.45, 0.99) | 0.08 (−0.14, 0.31) | 0.461 |
| WOMAC physical function | |||||||||
| Post-consultation | 283 | 12.28 | 7.61 | 233 | 12.09 | 6.87 | – | – | – |
| 3 months | 250 | 10.56 | 7.73 | 196 | 10.32 | 6.84 | −0.36 (−1.24, 0.52) | −0.05 (−0.17, 0.07) | 0.417 |
| 6 months | 219 | 9.67 | 7.21 | 175 | 10.46 | 7.10 | −0.53 (−1.68, 0.61) | −0.07 (−0.23, 0.08) | 0.362 |
| 12 months | 191 | 10.24 | 7.53 | 161 | 9.28 | 6.65 | 0.13 (−1.64, 1.90) | 0.02 (−0.23, 0.26) | 0.884 |
| AIMS 2 hand & finger function | |||||||||
| Post-consultation | 279 | 1.62 | 2.04 | 233 | 1.82 | 2.53 | – | – | – |
| 3 months | 243 | 1.64 | 2.09 | 197 | 1.56 | 2.05 | 0.16 (−0.16, 0.48) | 0.07 (−0.07, 0.21) | 0.331 |
| 6 months | 220 | 1.55 | 2.10 | 175 | 1.73 | 2.26 | 0.02 (−0.35, 0.39) | 0.01 (−0.15, 0.17) | 0.932 |
| 12 months | 192 | 1.51 | 2.11 | 161 | 1.70 | 2.21 | −0.17 (−0.67, 0.33) | −0.07 (−0.29, 0.14) | 0.505 |
| IPAQ | |||||||||
| Post-consultation | 200 | 2745 | 3285 | 171 | 3125 | 3830 | – | – | – |
| 3 months | 182 | 2378 | 2912 | 157 | 3306 | 4073 | −693 (−1447, 60) | −0.20 (−0.41, 0.02) | 0.071 |
| 6 months | 181 | 2200 | 2967 | 144 | 2519 | 2787 | −629 (−1397, 139) | −0.18 (−0.41,0.02) | 0.108 |
| 12 months | 167 | 2356 | 2414 | 142 | 3041 | 3460 | −595 (−1396, 207) | −0.17 (−0.39,0.06) | 0.146 |
| Physical activity for the elderly (PASE) | |||||||||
| Post-consultation | 237 | 138.7 | 75.9 | 195 | 147.5 | 85.3 | – | – | – |
| 3 months | 203 | 123.6 | 72.0 | 176 | 149.1 | 90.6 | −22.1 (−35.7, −8.5) | −0.28 (−0.44, −0.11) | 0.001 |
| 6 months | 190 | 123.0 | 68.7 | 143 | 136.2 | 73.2 | −18.3 (−34.0, −2.6) | −0.23 (−0.42, −0.03) | 0.022 |
| 12 months | 157 | 134.2 | 69.6 | 142 | 148.2 | 77.9 | −17.0 (−38.2, 4.1) | −0.21 (−0.48, 0.05) | 0.127 |
| PHQ8 | |||||||||
| Post-consultation | 286 | 5.02 | 5.24 | 235 | 4.45 | 4.65 | – | – | – |
| 3 months | 248 | 4.36 | 4.50 | 199 | 3.85 | 4.64 | 0.38 (−0.29, 1.04) | 0.08 (−0.06, 0.21) | 0.265 |
| 6 months | 223 | 4.07 | 4.87 | 174 | 4.29 | 4.74 | 0.02 (−0.74, 0.78) | 0.00 (−0.15, 0.16) | 0.965 |
| 12 months | 194 | 4.06 | 4.74 | 162 | 3.96 | 4.81 | −0.16 (−1.18, 0.86) | −0.03 (−0.24, 0.17) | 0.759 |
| GAD7 | |||||||||
| Post-consultation | 273 | 3.70 | 4.89 | 231 | 3.22 | 4.33 | – | – | – |
| 3 months | 242 | 3.16 | 4.32 | 195 | 2.90 | 4.60 | −0.07 (−0.72, 0.58) | −0.02 (−0.15, 0.12) | 0.825 |
| 6 months | 212 | 2.72 | 4.05 | 172 | 2.73 | 4.28 | 0.60 (−0.15, 1.35) | 0.13 (−0.03, 0.29) | 0.115 |
| 12 months | 187 | 2.90 | 4.31 | 159 | 2.75 | 3.84 | −0.45 (−1.47, 0.57) | −0.10 (−0.32, 0.12) | 0.388 |
| SF-12 MCS | |||||||||
| Post-consultation | 280 | 50.24 | 11.34 | 231 | 51.14 | 10.91 | – | – | – |
| 3 months | 250 | 51.04 | 10.74 | 204 | 50.91 | 11.13 | 0.09 (−1.64, 1.82) | 0.01 (−0.15, 0.16) | 0.917 |
| 6 months | 229 | 50.90 | 10.81 | 180 | 50.79 | 10.66 | −0.18 (−2.11, 1.75) | −0.02 (−0.19, 0.16) | 0.853 |
| 12 months | 200 | 51.49 | 10.74 | 166 | 51.34 | 10.11 | 0.08 (−2.39, 2.55) | 0.01 (−0.22, 0.23) | 0.947 |
| Arthritis self-efficacy pain subscale | |||||||||
| Post-consultation | 282 | 5.40 | 1.99 | 232 | 5.39 | 2.11 | – | – | – |
| 3 months | 246 | 5.82 | 2.18 | 190 | 5.82 | 2.13 | −0.13 (−0.50, 0.25) | −0.06 (−0.25, 0.12) | 0.516 |
| 6 months | 218 | 5.86 | 2.08 | 173 | 5.82 | 2.31 | 0.00 (−0.44, 0.43) | 0.00 (−0.22, 0.21) | 0.984 |
| 12 months | 197 | 5.83 | 2.24 | 157 | 6.04 | 2.17 | −0.15 (−0.74, 0.44) | −0.07 (−0.36, 0.22) | 0.615 |
| Patient enablement | |||||||||
| Post-consultation | – | – | – | – | – | – | – | – | – |
| 3 months | 253 | 2.82 | 3.16 | 202 | 2.61 | 3.25 | 0.86 (0.10, 1.63) | 0.27 (0.03, 0.51) | 0.027 |
| 6 months | 224 | 3.21 | 3.44 | 178 | 2.29 | 2.96 | 1.34 (0.59, 2.10) | 0.42 (0.18, 0.65) | <0.001 |
| 12 months | 198 | 2.80 | 3.18 | 162 | 2.59 | 3.19 | 0.88 (0.05, 1.71) | 0.27 (0.02, 0.53) | 0.039 |
ICC (unadjusted): Hip pain <0.001; Knee pain <0.001; Hand pain 0.003; Foot pain 0.016; WOMAC-pf <0.001; AIMS <0.001; IPAQ <0.001; PASE <0.001; PHQ <0.001; GAD <0.001; SF-MCS 0.001; self-efficacy 0.001; patient enablement 0.010.
∗
Calculated as mean difference for Intervention – Control score by linear mixed modelling adjusted for age, gender, practice size and corresponding baseline measures (clustering by GP Practice accounted for in the mixed model).
†
Mean difference relative to pooled ‘baseline’ (post-consultation) SD except for patient enablement for which the relative SD was that of the SD at follow up (since no baseline patient enablement was collected).