Does Clinical Presentation Predict Response to a Nonsurgical Chronic Disease Management Program for Endstage Hip and Knee Osteoarthritis?
Does Clinical Presentation Predict Response to a Nonsurgical Chronic Disease Management Program for Endstage Hip and Knee Osteoarthritis?
复制标题
DOI：
10.3899/jrheum.131475
复制
发表时间：
2014-11-01
影响因子：
3.9
通讯作者：
Hunter, David J.
中科院分区：
文献类型：
--
作者：
Eyles, Jillian P.;Lucas, Barbara R.;Hunter, David J.
Objective.确定参与髋关节和膝关节骨关节炎（OA）慢性疾病管理项目6个月后积极响应的参与者的基线特征。这项前瞻性队列研究评估了559名参与者在基线和6个月后参加骨关节炎慢性护理计划。缓解定义为西安大略和麦克马斯特大学关节炎指数总体评分的18%和9分绝对改善的最小临床重要差异。采用多变量logistic回归模型来确定疗效的预测因素。共有308名参与者提供了完整的数据。在研究期间退出的受试者被插补为无应答者。三个变量与反应独立相关：信号关节（膝关节与髋关节），性别和高水平的合并症。指数关节和性别在多变量模型中具有显著性，但该模型不是反应的敏感预测因子。髋关节和膝关节OA慢性疾病管理计划的反应的强预测因子尚未确定。在未来的研究中应考虑所发现的重要预测因素。
Objective. To identify baseline characteristics of participants who will respond favorably following 6 months of participation in a chronic disease management program for hip and knee osteoarthritis (OA).Methods. This prospective cohort study assessed 559 participants at baseline and following 6 months of participation in the Osteoarthritis Chronic Care Program. Response was defined as the minimal clinically important difference of an 18% and 9-point absolute improvement in the Western Ontario and McMaster Universities Arthritis Index global score. Multivariate logistic regression modeling was used to identify predictors of response.Results. Complete data were available for 308 participants. Those who withdrew within the study period were imputed as nonresponders. Three variables were independently associated with response: signal joint (knee vs hip), sex, and high level of comorbidity. Index joint and sex were significant in the multivariate model, but the model was not a sensitive predictor of response.Conclusion. Strong predictors of response to a chronic disease management program for hip and knee OA were not identified. The significant predictors that were found should be considered in future studies.