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ARTIST (osteoarthritis intervention standardized) study of standardised consultation versus usual care for patients with osteoarthritis of the knee in primary care in France: pragmatic randomised controlled trial.

Ravaud P, Flipo RM, Boutron I, Roy C, Mahmoudi A, Giraudeau B, Pham T - BMJ (2009)

Bottom Line: At four months, taking into account the clustering effect, the decrease in weight was greater in the standardised consultation group than in the usual care group (mean -1.11 (SD 2.49) kg v -0.37 (2.39) kg; P=0.007).The physical activity score was higher for the standardised consultation group than for the usual care group (mean 0.20 (0.65) v 0.04 (0.78); P=0.013).The standardised consultation and usual care groups did not differ in secondary outcomes, except for global assessment of disease activity (0-10 numeric scale: mean -1.66 (2.26) v -0.90 (2.48); P=0.003) and pain level (0-10 numeric scale: mean -1.65 (2.32) v -1.18 (2.58); P=0.04).

View Article: PubMed Central - PubMed

Affiliation: INSERM, U738, Paris, France. philippe.ravaud@bch.ap-hop-paris.fr

ABSTRACT

Objective: To evaluate the impact of standardised consultations on patients with osteoarthritis of the knee.

Design: Open pragmatic cluster randomised controlled trial.

Setting: Primary care in France.

Participants: 198 primary care rheumatologists, each of whom had to include two consecutive patients who met the American College of Rheumatology criteria for osteoarthritis of the knee.

Interventions: Standardised consultation was provided during three goal oriented visits (education on osteoarthritis and treatment management; information on physical exercises; information on weight loss) or usual care.

Main outcome measures: Change in body weight and in time spent on physical exercises (Baecke index) at four months.

Results: 336 patients were included (154 allocated to standardised consultation and 182 to usual care). Nine patients were excluded because of lack of baseline data (standardised consultation, n=8; usual care, n=1). At four months, taking into account the clustering effect, the decrease in weight was greater in the standardised consultation group than in the usual care group (mean -1.11 (SD 2.49) kg v -0.37 (2.39) kg; P=0.007). The physical activity score was higher for the standardised consultation group than for the usual care group (mean 0.20 (0.65) v 0.04 (0.78); P=0.013). The standardised consultation and usual care groups did not differ in secondary outcomes, except for global assessment of disease activity (0-10 numeric scale: mean -1.66 (2.26) v -0.90 (2.48); P=0.003) and pain level (0-10 numeric scale: mean -1.65 (2.32) v -1.18 (2.58); P=0.04).

Conclusions: A structured consultation programme for patients with osteoarthritis of the knee resulted in short term improvement in weight loss and time spent on physical activity.

Trial registration: Clinical trials NCT00462319.

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Related in: MedlinePlus

Flow diagram of participants in the trial
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fig1: Flow diagram of participants in the trial

Mentions: The figure shows the flow of clusters and individual participants through each stage. Because of difficulties in recruitment, we included and randomised only 198 rheumatologists between May 2005 and June 2006; 137 rheumatologists included two patients, and 53 included only one patient. (We excluded six rheumatologists (who included nine patients: eight in the standardised consultation group and one in the usual care group) because they did not complete the baseline data for their patients and two because they did not include any patients). Consequently, at four months, data were available for analysis for 327 patients—146 in the standardised consultation group and 181 in the usual care group.


ARTIST (osteoarthritis intervention standardized) study of standardised consultation versus usual care for patients with osteoarthritis of the knee in primary care in France: pragmatic randomised controlled trial.

Ravaud P, Flipo RM, Boutron I, Roy C, Mahmoudi A, Giraudeau B, Pham T - BMJ (2009)

Flow diagram of participants in the trial
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651104&req=5

fig1: Flow diagram of participants in the trial
Mentions: The figure shows the flow of clusters and individual participants through each stage. Because of difficulties in recruitment, we included and randomised only 198 rheumatologists between May 2005 and June 2006; 137 rheumatologists included two patients, and 53 included only one patient. (We excluded six rheumatologists (who included nine patients: eight in the standardised consultation group and one in the usual care group) because they did not complete the baseline data for their patients and two because they did not include any patients). Consequently, at four months, data were available for analysis for 327 patients—146 in the standardised consultation group and 181 in the usual care group.

Bottom Line: At four months, taking into account the clustering effect, the decrease in weight was greater in the standardised consultation group than in the usual care group (mean -1.11 (SD 2.49) kg v -0.37 (2.39) kg; P=0.007).The physical activity score was higher for the standardised consultation group than for the usual care group (mean 0.20 (0.65) v 0.04 (0.78); P=0.013).The standardised consultation and usual care groups did not differ in secondary outcomes, except for global assessment of disease activity (0-10 numeric scale: mean -1.66 (2.26) v -0.90 (2.48); P=0.003) and pain level (0-10 numeric scale: mean -1.65 (2.32) v -1.18 (2.58); P=0.04).

View Article: PubMed Central - PubMed

Affiliation: INSERM, U738, Paris, France. philippe.ravaud@bch.ap-hop-paris.fr

ABSTRACT

Objective: To evaluate the impact of standardised consultations on patients with osteoarthritis of the knee.

Design: Open pragmatic cluster randomised controlled trial.

Setting: Primary care in France.

Participants: 198 primary care rheumatologists, each of whom had to include two consecutive patients who met the American College of Rheumatology criteria for osteoarthritis of the knee.

Interventions: Standardised consultation was provided during three goal oriented visits (education on osteoarthritis and treatment management; information on physical exercises; information on weight loss) or usual care.

Main outcome measures: Change in body weight and in time spent on physical exercises (Baecke index) at four months.

Results: 336 patients were included (154 allocated to standardised consultation and 182 to usual care). Nine patients were excluded because of lack of baseline data (standardised consultation, n=8; usual care, n=1). At four months, taking into account the clustering effect, the decrease in weight was greater in the standardised consultation group than in the usual care group (mean -1.11 (SD 2.49) kg v -0.37 (2.39) kg; P=0.007). The physical activity score was higher for the standardised consultation group than for the usual care group (mean 0.20 (0.65) v 0.04 (0.78); P=0.013). The standardised consultation and usual care groups did not differ in secondary outcomes, except for global assessment of disease activity (0-10 numeric scale: mean -1.66 (2.26) v -0.90 (2.48); P=0.003) and pain level (0-10 numeric scale: mean -1.65 (2.32) v -1.18 (2.58); P=0.04).

Conclusions: A structured consultation programme for patients with osteoarthritis of the knee resulted in short term improvement in weight loss and time spent on physical activity.

Trial registration: Clinical trials NCT00462319.

Show MeSH
Related in: MedlinePlus