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The Web-Based Osteoarthritis Management Resource My Joint Pain Improves Quality of Care: A Quasi-Experimental Study.

Umapathy H, Bennell K, Dickson C, Dobson F, Fransen M, Jones G, Hunter DJ - J. Med. Internet Res. (2015)

Bottom Line: Following 12 months of exposure to the website, there were significant improvements for users compared to nonusers in self-management (absolute change score 15% vs 2%, P=.001) and weight reduction (absolute change scores 3% vs -6%, P=.03) measured on the OAQI.The My Joint Pain Web resource does not significantly improve overall heiQ, but does improve other important aspects of quality of care in people with hip and/or knee OA.Further work is required to improve engagement with the website and the quality of information delivered in order to provide a greater impact.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Bone and Joint Research, The Kolling Institute, Department of Rheumatology, University of Sydney, Sydney, Australia.

ABSTRACT

Background: Despite the availability of evidence-based guidelines for conservative treatment of osteoarthritis (OA), management is often confined to the use of analgesics and waiting for eventual total joint replacement. This suggests a gap in knowledge for persons with OA regarding the many different treatments available to them.

Objective: Our objective was to evaluate outcomes after usage of a Web-based resource called My Joint Pain that contains tailored, evidence-based information and tools aimed to improve self-management of OA on self-management and change in knowledge.

Methods: A quasi-experimental design was used to evaluate the My Joint Pain website intervention over a 12-month period. The intervention provided participants with general and user-specific information, monthly assessments with validated instruments, and progress-tracking tools. A nationwide convenience sample of 195 participants with self-assessed hip and/or knee OA completed both baseline and 12-month questionnaires (users: n=104; nonusers: n=91). The primary outcome measure was the Health Evaluation Impact Questionnaire (heiQ) to evaluate 8 different domains (health-directed activity, positive and active engagement in life, emotional distress, self-monitoring and insight, constructive attitudes and approaches, skill and technique acquisition, social integration and support, health service navigation) and the secondary outcome measure was the 17-item Osteoarthritis Quality Indicator (OAQI) questionnaire to evaluate the change in appropriateness of care received by participants. Independent t tests were used to compare changes between groups for the heiQ and chi-square tests to identify changes within and between groups from baseline to 12 months for each OAQI item.

Results: Baseline demographics between groups were similar for gender (152/195, 77.9% female), age (mean 60, SD 9 years) and body mass index (mean 31.1, SD 6.8 kg/m(2)). With the exception of health service navigation, mean effect sizes from all other heiQ domains showed a positive trend for My Joint Pain users compared to the nonusers, although the differences between groups did not reach statistical significance. Within-group changes also showed improvements among the users of the My Joint Pain website for self-management (absolute change score=15%, P=.03), lifestyle (absolute change score=16%, P=.02), and physical activity (absolute change score=11%, P=.04), with no significant improvements for the nonusers. Following 12 months of exposure to the website, there were significant improvements for users compared to nonusers in self-management (absolute change score 15% vs 2%, P=.001) and weight reduction (absolute change scores 3% vs -6%, P=.03) measured on the OAQI.

Conclusions: The My Joint Pain Web resource does not significantly improve overall heiQ, but does improve other important aspects of quality of care in people with hip and/or knee OA. Further work is required to improve engagement with the website and the quality of information delivered in order to provide a greater impact.

No MeSH data available.


Related in: MedlinePlus

Mean change scores (standard error) between users and nonusers of the My Joint Pain website over a 12-month period for each Health Evaluation Impact Questionnaire domain.
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figure1: Mean change scores (standard error) between users and nonusers of the My Joint Pain website over a 12-month period for each Health Evaluation Impact Questionnaire domain.

Mentions: All domains, except health service navigation, showed a clear positive trend in change scores (the difference between follow-up and baseline) in the intervention group relative to nonusers, although the differences in change between the groups were not statistically significant (Figure 1). Mean change scores were calculated as the follow-up score minus the baseline score within each domain and within each group. Positive change scores indicated improvement. P values were the result of independent t tests comparing the change between groups. All questions in the evaluation were asked in the positive with the exception of emotional distress for which lower scores indicated a more favorable outcome. The improvements appeared particularly pronounced in health-directed activity (P=.16), emotional distress (P=.34), and skill and technique acquisition (P=.20), but none met statistical significance.


The Web-Based Osteoarthritis Management Resource My Joint Pain Improves Quality of Care: A Quasi-Experimental Study.

Umapathy H, Bennell K, Dickson C, Dobson F, Fransen M, Jones G, Hunter DJ - J. Med. Internet Res. (2015)

Mean change scores (standard error) between users and nonusers of the My Joint Pain website over a 12-month period for each Health Evaluation Impact Questionnaire domain.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526979&req=5

figure1: Mean change scores (standard error) between users and nonusers of the My Joint Pain website over a 12-month period for each Health Evaluation Impact Questionnaire domain.
Mentions: All domains, except health service navigation, showed a clear positive trend in change scores (the difference between follow-up and baseline) in the intervention group relative to nonusers, although the differences in change between the groups were not statistically significant (Figure 1). Mean change scores were calculated as the follow-up score minus the baseline score within each domain and within each group. Positive change scores indicated improvement. P values were the result of independent t tests comparing the change between groups. All questions in the evaluation were asked in the positive with the exception of emotional distress for which lower scores indicated a more favorable outcome. The improvements appeared particularly pronounced in health-directed activity (P=.16), emotional distress (P=.34), and skill and technique acquisition (P=.20), but none met statistical significance.

Bottom Line: Following 12 months of exposure to the website, there were significant improvements for users compared to nonusers in self-management (absolute change score 15% vs 2%, P=.001) and weight reduction (absolute change scores 3% vs -6%, P=.03) measured on the OAQI.The My Joint Pain Web resource does not significantly improve overall heiQ, but does improve other important aspects of quality of care in people with hip and/or knee OA.Further work is required to improve engagement with the website and the quality of information delivered in order to provide a greater impact.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute of Bone and Joint Research, The Kolling Institute, Department of Rheumatology, University of Sydney, Sydney, Australia.

ABSTRACT

Background: Despite the availability of evidence-based guidelines for conservative treatment of osteoarthritis (OA), management is often confined to the use of analgesics and waiting for eventual total joint replacement. This suggests a gap in knowledge for persons with OA regarding the many different treatments available to them.

Objective: Our objective was to evaluate outcomes after usage of a Web-based resource called My Joint Pain that contains tailored, evidence-based information and tools aimed to improve self-management of OA on self-management and change in knowledge.

Methods: A quasi-experimental design was used to evaluate the My Joint Pain website intervention over a 12-month period. The intervention provided participants with general and user-specific information, monthly assessments with validated instruments, and progress-tracking tools. A nationwide convenience sample of 195 participants with self-assessed hip and/or knee OA completed both baseline and 12-month questionnaires (users: n=104; nonusers: n=91). The primary outcome measure was the Health Evaluation Impact Questionnaire (heiQ) to evaluate 8 different domains (health-directed activity, positive and active engagement in life, emotional distress, self-monitoring and insight, constructive attitudes and approaches, skill and technique acquisition, social integration and support, health service navigation) and the secondary outcome measure was the 17-item Osteoarthritis Quality Indicator (OAQI) questionnaire to evaluate the change in appropriateness of care received by participants. Independent t tests were used to compare changes between groups for the heiQ and chi-square tests to identify changes within and between groups from baseline to 12 months for each OAQI item.

Results: Baseline demographics between groups were similar for gender (152/195, 77.9% female), age (mean 60, SD 9 years) and body mass index (mean 31.1, SD 6.8 kg/m(2)). With the exception of health service navigation, mean effect sizes from all other heiQ domains showed a positive trend for My Joint Pain users compared to the nonusers, although the differences between groups did not reach statistical significance. Within-group changes also showed improvements among the users of the My Joint Pain website for self-management (absolute change score=15%, P=.03), lifestyle (absolute change score=16%, P=.02), and physical activity (absolute change score=11%, P=.04), with no significant improvements for the nonusers. Following 12 months of exposure to the website, there were significant improvements for users compared to nonusers in self-management (absolute change score 15% vs 2%, P=.001) and weight reduction (absolute change scores 3% vs -6%, P=.03) measured on the OAQI.

Conclusions: The My Joint Pain Web resource does not significantly improve overall heiQ, but does improve other important aspects of quality of care in people with hip and/or knee OA. Further work is required to improve engagement with the website and the quality of information delivered in order to provide a greater impact.

No MeSH data available.


Related in: MedlinePlus