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Study Suggests Telephone-Based Self-Management Program Improves Pain among Veterans with Osteoarthritis


BACKGROUND:
Optimal management of osteoarthritis involves both pharmacological intervention and behavioral strategies, i.e., exercise and weight management. Previous studies have shown that self-management programs can improve both healthy behaviors and outcomes among patients with osteoarthritis. This study examined the effectiveness of a one-year, telephone-based self-management support intervention for 461 Veterans with symptomatic hip and/or knee osteoarthritis who received VA primary care at the Durham VAMC. Veterans were randomly assigned to one of three interventions: osteoarthritis self-management, health education, or usual care. The self-management intervention had two main components: 1) providing educational materials related to managing osteoarthritis, and 2) helping participants develop goals and action plans related to managing this condition. It also included 12 monthly telephone calls with a health educator. Veterans in the ‘health education intervention’ were provided with non-osteoarthritis educational materials and 12 monthly telephone calls related to general health screening topics (e.g., hypertension, cholesterol, cancer). Veterans in ‘usual care’ were provided written osteoarthritis self-management materials after completing follow-up assessments, but no other intervention. At baseline and 12 months, investigators compared pain scores among Veterans in the three interventions. They also assessed physical function and costs.

FINDINGS:

  • A telephone-based self-management program produced moderate improvements in pain among Veterans with osteoarthritis, particularly compared with a general health education intervention.
  • The mean pain score among Veterans in the osteoarthritis self-management intervention was 0.4 points lower, indicating improvement in pain, compared to participants in the usual care arm, and 0.6 points lower compared to participants in the health education intervention.
  • There were no significant differences found between Veterans participating in the three interventions in terms of function or overall mobility. However, the self-management group had greater improvement on the walking and bending subscale measure.
  • When the training costs for the health educator were not included, the per-Veteran costs were $107 for the osteoarthritis self-management intervention vs. $51 for the health education intervention.

LIMITATIONS:

  • This study was conducted at only one VAMC.
  • The same health educator delivered both the osteoarthritis self-management and health education interventions, which could raise the risk of contamination between intervention groups; also, the average length of calls was shorter for the health education arm.

AUTHOR/FUNDING INFORMATION:
This study was funded by HSR&D (IIR 04-016, RCS 91-408 and RCS 08-027). Drs. Weinberger and Bosworth were supported by HSR&D Career Scientist Awards. All authors are part of HSR&D’s Center for Health Services Research in Primary Care, Durham, NC.


PubMed Logo Allen K, Oddone E, Coffman C, Datta S, Juntilla K, Lindquist J, Walker T, Weinberger M, and Bosworth H. Telephone-Based Self-Management of Osteoarthritis: A Randomized, Controlled Trial. Annals of Internal Medicine November 2, 2010;153(9):570-79.

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What are HSR&D Publication Briefs?

HSR&D requires notification by HSR&D-funded investigators about all articles accepted for publication. These journal articles are reviewed by HSR&D and publication briefs or summaries are written for a select number of articles that are then forwarded to VHA Central Office leadership to keep them informed about important findings or information. Articles to be summarized are selected by HSR&D based on timeliness of the findings, interest of leadership, or potential impact on the organization. Publication briefs are written for only a small number of HSR&D published articles. Visit the HSR&D citations database for a complete listing of HSR&D articles and presentations.