Examining patient activation and other factors associated with changes in pain and function following best evidence osteoarthritis care.

OBJECTIVES

The primary objective was to examine baseline patient activation as a prognostic factor for changes in pain and function following participation in an osteoarthritis management program. The secondary objective was to examine other prognostic factors from existing literature (e.g. employment, functional performance, depression, comorbidities).

METHOD: One-hundred-and-eleven participants with knee osteoarthritis were assessed at 0-, 12- and 26-weeks in this prospective clinical cohort. Demographic variables, timed-up-and-go (TUG), patient activation measure (PAM-13), Depression Anxiety Stress Scale and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were collected. Multivariable linear regression examined relationships between prognostic factors and pain and function at 12- and 26-weeks.

RESULTS

Complete 12- and 26-week data were available for 89 and 74 participants respectively, 66 ​% female, 66.8 (SD 10.0) years, 74 ​% unemployed, 66 ​% finished high school or higher, 12 ​% on joint arthroplasty waitlists. Baseline PAM-13 scores were not associated with changes in pain or function at 12- or 26-weeks. Employment status (β ​= ​9.17 (95 ​% CI 2.11, 16.24), p ​= ​0.01) and TUG (β ​= ​-1.20 (95 ​% CI -1.91, -0.49), p ​< ​0.01) were associated with changes in pain at week-12. Employment status (β ​= ​11.60 (95 ​% CI 5.31, 17.90), p ​< ​0.01) and TUG (β ​= ​-1.10 (95%CI -1.78, -0.43), p ​< ​0.01) were associated with 12-week function. Baseline TUG (β ​= ​-1.32 (95 ​% CI -2.40, -0.23), p ​= ​0.02) was associated with week-26 WOMAC function.

CONCLUSIONS

Baseline PAM-13 scores were not associated with changes in pain and function at any timepoint. Employment status and TUG were associated with changes in pain and function at 12-weeks, TUG was associated with 26-week function.