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Objective: To determine the cost-effectiveness (CE) of exercise therapy (intervention group) compared to 'general practitioner (GP) care' (control group) in patients with hip osteoarthritis (OA) in primary care. Method: This cost-utility analysis was conducted with 120 GPs in the Netherlands from the societal and healthcare perspective. Data on direct medical costs, productivity costs and quality of life (QoL) was collected using standardised questionnaires which were sent to the patients at baseline and at 6, 13, 26, 39 and 52 weeks follow-up. All costs were based on Euro 2011 cost data. Results: A total of 203 patients were included. The annual direct medical costs per patient were significantly lower for the intervention group ((sic) 1233) compared to the control group ((sic) 1331). The average annual societal costs per patient were lower in the intervention group ((sic) 2634 vs (sic) 3241). Productivity costs were higher than direct medical costs. There was a very small adjusted difference in QoL of 0.006 in favour of the control group (95% CI: -0.04 to +0.02). Conclusion: Our study revealed that exercise therapy is probably cost saving, without the risk of noteworthy negative health effects. (C) 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

Objective: To assess the effectiveness of exercise therapy added to general practitioner (GP) care compared with GP care alone, in patients with hip osteoarthritis (OA) during 12 months follow-up. Methods: We performed a multi-center parallel pragmatic randomized controlled trial in 120 general practices in the Netherlands. 203 patients, aged >= 45 years, with a new episode of hip complaints, complying with the ACR criteria for hip OA were randomized to the intervention group (n = 101; GP care with additional exercise therapy) or the control group (n = 102; GP care only). GP care was given by patient's own GP. The intervention group received, in addition, a maximum of 12 exercise therapy sessions in the first 3 months and hereafter three booster sessions. Blinding was not possible. Primary outcomes were hip pain and hip-related function measured with the HOOS questionnaire (score 0-100). Results: The overall estimates on hip pain and function during the 12-month follow-up showed no between-group difference (intention-to-treat). At 3-months follow-up there was a statistically significant between-group difference for HOOS pain -3.7 (95% CI: -7.3; -0.2), effect size -0.23 and HOOS function -5.3 (95% CI: -8.9; -1.6), effect size -0.31. No adverse events were reported. Conclusions: No differences were found during 12-months follow-up on pain and function. At 3-months follow-up, pain and function scores differed in favor of patients allocated to the additional exercise therapy compared with GP care alone. (C) 2015 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

usual care for more than 6 months were included. Patients were randomized into a control group receiving usual care or into an intervention group receiving usual care with 3 additional intra articular injections with high MW HA. Data on pain during rest / activity, function and global assessment were collected during 12 months follow-up. The primary outcome was defined as response to therapy according to OMERACT-OARSI criteria (improvement of at least 20% in at least 2 of the 3 following domains: pain in rest / pain during activity, function and patients global assessment) after 12 months of follow-up. Adverse events were registered during follow-up. Results: In total, 156 subjects were included of which 77 patients in the intervention group and 79 subjects in the control group. There were statistically significant more responders in the intervention groupwhen pain during rest was included in responder criteria (51.9% versus 26.7%, p1⁄40.001) after 12 months. With pain during activity as responder criteria, this difference was also statistically significant favouring the intervention group (51.9% versus 25.3%, p1⁄40.001). Also on the individual outcomes of the responder criteria significant differences were found between both groups favouring the intervention group. Conclusions: Intra articular HA added to usual care leads to significantly more responders according to OMERACT-OARSI criteria after 12 months.