Preliminary Efficacy of a Self-Management Programme to Improve Quality-of-Life in Patients With Obesity and Osteoarthritis Awaiting Arthroplasty: A Randomised Trial.

BACKGROUND

Obesity is a risk factor for osteoarthritis and total hip/knee joint replacement and can lead to poorer outcomes following surgical interventions.

AIM

This work aimed to determine the preliminary efficacy of a self-management programme versus usual care in improving health-related quality of life in obese patients with osteoarthritis awaiting joint replacement.

METHODS

This was a two-group parallel randomised trial involving patients with obesity and osteoarthritis who were awaiting hip or knee arthroplasty. Patients were randomly allocated to the Flinders Program of self-management support plus usual care or usual care alone groups. Primary outcomes at 10 months were Short-Form Health Survey (SF-36) and Osteoarthritis of Knee/Hip Quality of Life (OAKHQoL).

RESULTS

Ninety-five patients were randomised to either intervention (n = 48) or usual care (n = 47) and analysed in an intent-to-treat analysis. While there was no intervention effect in SF-36, evidence was in favour of intervention for OAKQoL improved social support (d = 0.43, 95% CI: 0.01-0.83) versus usual care (d = -0.01, 95% CI: -0.41 to 0.42) (p = 0.03). Similarly, intervention patients experienced larger improvements for social activity (d = 0.47; 95% CI: 0.05-0.89) versus usual care (d = -0.16; 95% CI: -0.58 to 0.25) (p = 0.005).

CONCLUSION

The intervention warrants examination in a larger trial to establish effectiveness among patients with obesity and osteoarthritis awaiting arthroplasty.

TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry ACTRN12615000674538.