Clinical Trial Details
— Status: Suspended
Administrative data
NCT number |
NCT05026580 |
Other study ID # |
EQ-5D-5L |
Secondary ID |
|
Status |
Suspended |
Phase |
|
First received |
|
Last updated |
|
Start date |
January 14, 2022 |
Est. completion date |
June 2024 |
Study information
Verified date |
November 2023 |
Source |
Joint Academy |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
Objectives: To examine changes in health-related quality of life (HRQL), pain and function
among patients with knee or hip osteoarthritis (OA) participating in digitally delivered
exercise and education treatment for up to 12 or 24 month.
Design: An observational longitudinal and repeated cross-sectional cohort study.
Investigators will include participants who have participated in the digitally delivered
exercise and education treatment program Joint Academy® for 3, 6 , 9 , 12 and if enough
patients also for 24 month. Investigators will analyze both cross-sectional samples at each
time point and a longitudinal sample that have participated for at least 12 month, with at
least one follow-up in between.
Outcomes: Investigators will analyze HRQL with EQ-5D-5L, pain with Numeric Rating Scale (NRS)
0-10 (best to worst) and function with 30-sec chair stand test (CST) at baseline and at 3, 6,
9,12 and if possible 24 months during the treatment. Main outcome will be change in level in
EQ-5D-5L dimensions. We will also analyze minimally clinical important changes (improved or
not) and mean changes in EQ-5D-5L index score, pain and 30-sec chair stand test (CST).
Logistic regression models and linear mixed models will be used for analysis. Analyses will
be performed for repeated cross-sectional samples and a longitudinal sample.
Description:
International treatment guidelines recommend exercise, education and weight control (if
needed) as first-line treatment for knee and hip osteoarthritis (OA). Still, evidence suggest
that less than 50% of OA patients have participated in first-line treatment before getting
joint replacement.
Several observational and randomised controlled trials (RCTs) show that exercise therapy is
effective in reducing pain, improving physical function and health-related quality of life
(HRQL) at clinically important levels in the short-term.
Quality of life is rated lower by people with OA compared to norm populations and measures of
well-being are increasingly used as outcomes in health interventions. Face-to-face first-line
OA treatment following the Better Care for persons with OsteoArthritis (BOA) or Good Life
with osteoArthritis in Denmark (GLA:D) initiatives seem to have small but clinically
significant effects on HRQL immediate after intervention, at six month and with maintained
improvements at one year for knee but not hip OA.
The digitally delivered first-line OA treatment program Joint Academy® (JA) was developed in
Sweden in 2016 in an attempt to improve implementation and adherence to guidelines. The
program is based on evidence from BOA. Initial observational studies show that both patients
with hip and knee OA had clinically important improvements in pain and function at six weeks
with sustained improvements up to 48 weeks of treatment. Further, HRQL dimensions mobility
and pain/discomfort significantly improved after six weeks, while others did not (self-care,
usual activities, and anxiety/depression. However, the long-term change in HRQL during
digitally delivered first-line OA treatment is not known.
Therefore, the aim is to identify changes in HRQL, pain and function, during up to12 months
of digitally delivered first-line treatment. A second aim was to examine if changes differs
between hip/knee and women/men.
Outcomes Outcomes were collected at start and at standardized time points during the
treatment. They were chosen based on the International Consortium for Health Outcomes
Measurement Standard Set for Hip & Knee Osteoarthritis (ICHOM), self-entered using the
digital program interface and stored in the JA database.
HRQL was evaluated every third month using the EuroQol-5 dimensions five level index
questionnaire (EQ-5D-5L), which is a generic quality of life measurement tool. The
questionnaire covers five dimensions of health: mobility, self-care, usual activities, pain
or discomfort, and anxiety or depression. The levels of severity range from no problems (1)
to extreme problems/unable to (5) and are recorded for each of the five dimensions. The raw
scores are also converted to a single EQ-5D index value using a scoring algorithm (British
tariff was used) ranging from -0.594 (worst perceived health state) to 1.00 (best perceived
health state). A change of ≥0.03 in the index was considered as minimally clinical important
change (MCIC) according to a comprehensive review of musculoskeletal disorders.
Joint pain was assessed using the Numerical Rating Scale (NRS), with the instruction Mark on
this scale how much pain you had the last week in your hip/knee, followed by a 0-10 scale
where 0 indicates No pain and 10 indicates Maximum pain. A difference of 15 of 100 for
absolute improvement (slightly or moderately) is considered as MCIC.
Physical function was assessed with the 30-s chair-stand test (CST) performed by the
participant with the help of an instruction video with a coupled visual timer. The patient
entered the performed number of repetitions after each test. The 30-s CST is recommended by
the Osteoarthritis Research Society International (OARSI) as a performance-based functional
test for knee and hip OA (Dobson 2013). A difference of two rises is considered as MCIC.
Data on the participants' overall health and characteristics such as OA location (hip/knee),
age, sex, educational level (), height, weight and medical conditions (xx) were collected at
inclusion.