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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1066 — Effects of a Telephone-Based Osteoarthritis Self-Management Program on Communication with Healthcare Providers

Allen KDBosworth HBCoffman CJLindquist JHSperber NRWeinberger M, and Oddone EZ, Durham COE;

Objectives:
Osteoarthritis (OA) self-management programs aim to improve patients’ communication with healthcare providers. These analyses examined whether an OA self-management program improved Veterans’ self-reported communication with providers and perceptions of participation in OA treatment decisions, overall and by race and education level.

Methods:
Participants (n = 515, mean age = 60, 93% male, 46% non-white) were Veterans enrolled in a randomized controlled trial of a 12-month telephone-based OA self-management program, compared to health education (HE) and usual care (UC) control groups. Outcomes included the Communication with Physicians Scale (CPS; range 0-5) and the Medical Outcomes Survey Participatory Decision-Making Scale (PDMS; range 0-100). Linear mixed modeling assessed differential improvement in CPS and PDMS between the OA arm and control arms, between white vs. non-white participants, and participants with some college vs. no college.

Results:
There were no overall intervention effects on change in CPS scores and no differences in change by race. However, compared with the UC group, OA intervention effects on CPS differed according to education (p = 0.03); in the OA group, CPS scores improved by 0.4 points for those with no college compared to 0.1 points for those with some college. There were no overall intervention effects on change in PDMS scores and no differences in effects according to education. However, there were differences in OA intervention effects on PDMS according to race, compared with both HE (p = 0.04) and UC (p = 0.06) groups. In the OA self-management group, whites improved by 7.5 points, whereas non-whites declined by 4.3 points. In both the HE and UC arms there were small improvements in PDMS scores for both whites and non-whites.

Implications:
This OA self-management program yielded greater improvement in communication with providers among Veterans with lower education levels. Non-whites’ decline in participatory decision-making scores may be due to a change in perception of how actively they participate in OA treatment decisions; a more robust intervention may be needed to increase participatory behaviors.

Impacts:
OA self-management programs may be particularly important to disseminate among Veterans with lower education levels and could improve not only symptoms but communication with providers and ultimately satisfaction with care.


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