AB1188-HPR Enhancing Patient Awareness of Symptoms May Lead to Poorer Outcomes after One Year– Results from A Randomized Controlled Trial

Background Patient education is recommended as a core treatment for hand, hip and knee osteoarthritis (OA), but little is known about the effects of the various modes of delivery. Objectives To examine the effects of an integrated outpatient OA clinic, including a brief, multidisciplinary educational programme for patients with hand, hip, knee, or generalized OA, compared to usual care, assessed 12 months later. Methods Patients referred to a rheumatology clinic with a clinical OA diagnosis were randomized to either usual individual care, or integrated care combined with a 3.5h multidisciplinary educational programme that included group interaction with discussions of symptoms and disease consequences. Outcomes included pain, fatigue, stiffness on numeric rating scales (NRS), and disease specific functioning reported on Australian/Canadian Hand Osteoarthritis Index (AUSCAN) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Group differences were examined by mixed model analyses with random intercept, adjusted for baseline values. Results Of 390 patients, 86.4% (n=337) were women, and mean age was 63.1 (SD 8.0) years. At 12 months the integrated care group reported more pain and fatigue compared to the usual care group (Table). No other significant differences were found. Table 1. Baseline values for the two groups, and differences between groups on patient health at 12 month follow-up (n=390) Outcome 12 months (95% CI) 12 months (95% CI) Difference between groups Integrated care (n=196)# Usual care (n=194)# at 12 months (p-value)† Pain (NRS) 5.3 (5.0, 5.6) 5.1 (4.8, 5.4) 0.25 (0.26) Fatigue (NRS) 4.6 (4.2, 5.0) 4.1 (3.6, 4.5) 0.55 (0.04)* Stiffness (NRS) 5.4 (5.1, 5.8) 5.3 (5.0, 5.7) 0.07 (0.77) AUSCAN pain 5.0 (4.7, 5.3) 4.6 (4.3, 4.9) 0.38 (0.02)* AUSCAN stiffness 4.7 (4.4, 5.0) 4.8 (4.5, 5.2) −0.11 (0.64) AUSCAN physical 4.9 (4.6, 5.1) 4.8 (4.5, 5.1) 0.09 (0.60) WOMAC pain 3.7 (3.3, 3.9) 3.8 (3.4, 4.1) −0.12 (0.57) WOMAC stiffness 4.4 (4.0, 4.8) 4.8 (4.4, 5.2) −0.37 (0.14) WOMAC physical 3.5 (3.2, 3.8) 3.6 (3.3, 3.9) −0.07 (0.70) #There were no significant differences between the two groups at baseline p>0.05. †Mixed model analyses with random intercept, adjusted for baseline values. Conclusions A brief, multidisciplinary educational programme may have increased awareness of symptoms, possibly resulting in poorer outcomes on hand pain and fatigue compared to usual care after one year. Disclosure of Interest None declared DOI 10