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前交叉韧带损伤后预防创伤后骨关节炎药物治疗的患者认知:一项定性内容分析

Patient Perceptions of Medication Therapy for Prevention of Posttraumatic Osteoarthritis Following Anterior Cruciate Ligament Injury: A Qualitative Content Analysis.

作者信息

Waddell Lily M, Mitchener Donald P, Frier Kelly C, Jones Morgan H, Losina Elena, Bansback Nick, Fraenkel Liana, Kim Jason S, Katz Jeffrey N, Selzer Faith, Easterbrook Adam

机构信息

Brigham and Women's Hospital, Boston, Massachusetts.

Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

出版信息

Arthritis Care Res (Hoboken). 2025 Jul;77(7):881-891. doi: 10.1002/acr.25508. Epub 2025 Mar 10.

Abstract

OBJECTIVE

Posttraumatic osteoarthritis (PTOA) accounts for nearly 12% of osteoarthritis incidences and often occurs after anterior cruciate ligament (ACL) tear. Ensuring the uptake of preventive treatments for PTOA requires that investigators and clinicians understand factors influencing patients to seek preventive therapies. This qualitative, descriptive study aimed to assess individuals' willingness to adopt a medication therapy for PTOA prevention following ACL injury.

METHODS

We enrolled participants who had an ACL tear within two years of enrollment. Study individuals participated in a semistructured interview or focus group. We reviewed audio transcriptions for accuracy, and then organized the data inductively, beginning with open coding of audio transcriptions using NVivo 12. Finally, using a qualitative content analysis approach, we identified, revised, and constructed themes and subthemes.

RESULTS

Twenty-five individuals (mean age 25 years, 60% women) participated. Participants were an average of 10 months after injury (mean 310 days, 95% confidence interval [CI] 249-371) and reported a mean Knee Injury and Osteoarthritis Outcome Score pain score of 80.3 (95% CI 74.5-86.2). We identified three main themes related to general treatment for PTOA (eg, unwanted side effects), medication treatment for PTOA (eg, concern about pill size and dose frequency), and clinical trial attributes (eg, time commitment).

CONCLUSION

Although participants expressed great interest in trying medication therapy for PTOA prevention, there was variability in which components of treatment mattered to them. Our results stress the importance of using qualitative approaches such as this one to inform the design of trials and treatments that real-world patients will pursue with enthusiasm.

摘要

目的

创伤后骨关节炎(PTOA)占骨关节炎发病率的近12%,常发生在前交叉韧带(ACL)撕裂后。要确保PTOA预防治疗的采用率,研究人员和临床医生需要了解影响患者寻求预防治疗的因素。这项定性描述性研究旨在评估个体在ACL损伤后采用药物治疗预防PTOA的意愿。

方法

我们招募了在入组后两年内发生ACL撕裂的参与者。研究对象参加了半结构化访谈或焦点小组。我们检查了音频转录的准确性,然后使用NVivo 12对音频转录进行开放式编码,以归纳方式组织数据。最后,采用定性内容分析方法,我们识别、修订并构建了主题和子主题。

结果

25名个体(平均年龄25岁,60%为女性)参与。参与者受伤后平均10个月(平均310天,95%置信区间[CI]249 - 371),报告的膝关节损伤和骨关节炎结局评分疼痛平均得分为80.3(95%CI 74.5 - 86.2)。我们确定了与PTOA一般治疗(如不良副作用)、PTOA药物治疗(如对药丸大小和给药频率的担忧)以及临床试验属性(如时间投入)相关的三个主要主题。

结论

尽管参与者对尝试药物治疗预防PTOA表现出极大兴趣,但治疗的哪些组成部分对他们重要存在差异。我们的结果强调了使用此类定性方法为现实世界患者会积极参与的试验和治疗设计提供信息的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/943e/12209493/729d44f9fd07/ACR-77-881-g001.jpg

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