Can an “osteoarthritis school” in orthopedic specialist health service improve self-management in people with hip- and knee osteoarthritis? A cohort study

Purpose: To evaluate an “osteoarthritis school” in orthopedic specialist health service with regard to self-management and physical function after four months and joint survival after one year, and investigate the extent to which patients with hip osteoarthritis (HOA) and knee osteoarthritis (KOA) have received core treatment before referral to an orthopedist. Design: Cohort study. Material: 290 patients referred from general practitioners to orthopedic specialist health service in Norway, and described with mild and moderate HOA or KOA, 60% with KOA, mean age 70 (range 48-89) years, 64% women. Method: A group-based “osteoarthritis school” led by an interdisciplinary team was offered instead of individual consultation with an orthopedist. Patient-reported quality of core treatment was measured with the OsteoArthritis Quality Indicator questionnaire. Changes in self-management and physical function were measured with Patient Activation Measure and Hip disability and Osteoarthritis Outcome Score or Knee injury and Osteoarthritis Outcome Score- Physical function Shortform. Number of patients undergoing joint prosthetic surgery within a year was retrieved form the Norwegian Arthroplasty Register. Results: Mean quality indicator pass rate was 32% (SD 21). There was an improvement in self-management by 7.4 points (p≤0.001) for KOA patients and 6 points (p=0.001) for HOA patients. Physical function was improved by 4.3 points for both KOA (p = 0.004) and HOA (p = 0.082) patients. Within one year, 64 patients had undergone joint prosthetic surgery, of which 36% of HOA patients and 13% of KOA patients. Conclusion: HOA and KOA patients received inadequate core treatment before referral to orthopedic specialist health service. Four months after “osteoarthritis school” the patients showed signs of improved disease management. One-fifth had undergone joint prosthetic surgery within one year