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Patient characteristics associated with a poor response to non-surgical multidisciplinary management of knee osteoarthritis: a multisite prospective longitudinal study in an advanced practice physiotherapist-led tertiary service

Authors :
Tracy Comans
Shaun O'Leary
Maree Raymer
Peter Window
Patrick Swete Kelly
Bula Elwell
Ian McLoughlin
Will O'Sullivan
Ben Phillips
Anneke Wake
Andrew Ralph
Helen O'Gorman
Ellen Jang
Andrew Hislop
Darryl Lee
Linda Garsden
Daniel Wickins
Michelle Cottrell
Asaduzzaman Khan
Steven McPhail
Source :
BMJ Open, Vol 10, Iss 10 (2020)
Publication Year :
2020
Publisher :
BMJ Publishing Group, 2020.

Abstract

Objectives To explore patient characteristics recorded at the initial consultation associated with a poor response to non-surgical multidisciplinary management of knee osteoarthritis (KOA) in tertiary care.Design Prospective multisite longitudinal study.Setting Advanced practice physiotherapist-led multidisciplinary orthopaedic service within eight tertiary hospitals.Participants 238 patients with KOA.Primary and secondary outcome measures Standardised measures were recorded in all patients prior to them receiving non-surgical multidisciplinary management in a tertiary hospital service across multiple sites. These measures were examined for their relationship with a poor response to management 6 months after the initial consultation using a 15-point Global Rating of Change measure (poor response (scores −7 to +1)/positive response (scores+2 to+7)). Generalised linear models with binomial family and logit link were used to examine which patient characteristics yielded the strongest relationship with a poor response to management as estimated by the OR (95% CI).Results Overall, 114 out of 238 (47.9%) participants recorded a poor response. The odds of a poor response decreased with higher patient expectations of benefit (OR 0.74 (0.63 to 0.87) per 1/10 point score increase) and higher self-reported knee function (OR 0.67 (0.51 to 0.89) per 10/100 point score increase) (p

Subjects

Subjects :
Medicine

Details

Language :
English
ISSN :
20446055
Volume :
10
Issue :
10
Database :
Directory of Open Access Journals
Journal :
BMJ Open
Publication Type :
Academic Journal
Accession number :
edsdoj.48e180798b7f4421936bd2eb158ecafc
Document Type :
article
Full Text :
https://doi.org/10.1136/bmjopen-2020-037070