Faculty of Medicine, Rheumatology & Rehabilitation Department, Zagazig University, Zagazig, Egypt.
Musculoskeletal Care. 2024 Dec;22(4):e1954. doi: 10.1002/msc.1954.
To measure the level of adherence of patients with primary knee osteoarthritis (KOA) to an interventional therapeutic and rehabilitation programme and investigate factors that hinder patients' adherence.
A total of 154 participants with primary knee osteoarthritis (KOA) were divided into intervention and control groups. The intervention protocol included patient education on the nature and treatment of KOA, therapeutic exercise, a weight loss programme for overweight patients, and a physical therapy programme. Participants were followed for 3 months. The Visual Analog Scale for Pain (VAS-p), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee Kellgren-Lawrence OA grading were measured before and after the intervention. Additionally, the Morisky adherence questionnaire and the WHO Multidimensional Framework for factors affecting adherence were assessed.
One fifty four participants with KOA were randomly allocated into intervention and control groups. A low level of adherence was detected in both groups (68.8% in the intervention group vs. 84.4% in the control group). Patients who followed the interventional programme were more adherent. Adherence to therapy was associated with a reduction in the Visual Analog Scale for Pain (VAS-p) (p = 0.016) and improved function as measured by WOMAC (p = 0.018). Factors primarily associated with patient non-adherence included unemployment (67.8%), low income (59.3%), no previous response to therapy (58.5%), less frequent follow-up visits (55.1%), lack of insurance (66.9%), difficult access to services (59.3%), and high cost of services (55.1%).
Adherence to treatment in OA patients is a significant concern and a common problem, appearing to be associated more with socioeconomic factors than with pain and function.
测量原发性膝关节骨关节炎（KOA）患者对干预性治疗和康复方案的依从程度，并探讨影响患者依从性的因素。
将 154 名原发性膝关节骨关节炎（KOA）患者分为干预组和对照组。干预方案包括对 KOA 的性质和治疗进行患者教育、治疗性运动、超重患者的减肥计划以及物理治疗方案。对参与者进行了 3 个月的随访。干预前后分别测量视觉模拟量表疼痛评分（VAS-p）、西安大略和麦克马斯特大学骨关节炎指数（WOMAC）和膝关节 Kellgren-Lawrence OA 分级。此外，还评估了 Morisky 依从性问卷和世界卫生组织影响依从性的多维框架。
154 名 KOA 患者被随机分配到干预组和对照组。两组患者的依从性均较低（干预组为 68.8%，对照组为 84.4%）。遵循干预方案的患者更依从。治疗依从性与视觉模拟量表疼痛评分（VAS-p）降低相关（p=0.016），WOMAC 功能改善（p=0.018）。与患者不依从相关的主要因素包括失业（67.8%）、收入低（59.3%）、既往无治疗反应（58.5%）、随访次数少（55.1%）、缺乏保险（66.9%）、服务获取困难（59.3%）和服务费用高（55.1%）。
OA 患者的治疗依从性是一个严重的问题，也是一个普遍存在的问题，似乎与社会经济因素的关系更为密切，而与疼痛和功能的关系不大。
