Pharmacist initiated intervention trial in osteoarthritis (PhIT-OA): A multidisciplinary intervention for knee osteoarthritis.

Scientist, Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver BC. .
Arthritis care & research 12/2012; 64(12). DOI: 10.1002/acr.21763
Source: PubMed

ABSTRACT BACKGROUND: Knee osteoarthritis (OA) is a commonly undiagnosed condition and care is often not provided. Pharmacists are uniquely placed for launching a multidisciplinary intervention for knee OA. METHODS: A cluster, randomized, controlled trial with pharmacies providing either the intervention or usual care (14 and 18 pharmacies, respectively). The intervention included a validated knee OA screening questionnaire, education, pain medication management, physiotherapy guided exercise and communication with the primary care physician. Usual care consisted of an educational pamphlet. OUTCOMES: The primary outcome was the pass rate on the Arthritis Foundation's quality indicators for OA. Secondary outcomes included the WOMAC, the Lower Extremity Function Scale (LEFS), Paper Adaptive Test-5D (PAT-5D) and Health Utilities Index Mark 3 (HUI3). RESULTS: 139 patients were assigned to the control (n=66) and intervention (n=73). There were no differences between groups in baseline measures. The overall quality indicator pass rate, was significantly higher in the intervention compared to the control arm (difference of 45.2%, 95% CI (34.5, 55.9). Significant improvements were observed for the intervention care group as compared to the usual care in the WOMAC global, pain and function scores at 3 and 6 months (all p<0.01), PAT-5D daily activity scores at three and six months (both p<0.05), PAT-5D pain scores at 6 months (p,0.05), HUI3 single-attribute pain score at 3 and 6 months, (all p<0.05) and the LEFS scores at 6 months (p<0.05). CONCLUSIONS: Pharmacists can launch a multidisciplinary intervention to identify knee OA cases, improve the utilization of treatments, and improve function, pain and QoL. © 2012 by the American College of Rheumatology.

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