Patient-reported outcomes to initiate a provider-patient dialog for the management of hip and knee osteoarthritis

Yvonne M Golightly; Kelli D Allen; Kirsten A Nyrop; Amanda E Nelson; Leigh F Callahan; Joanne M Jordan

doi:10.1016/j.semarthrit.2015.04.008

Patient-reported outcomes to initiate a provider-patient dialog for the management of hip and knee osteoarthritis

Semin Arthritis Rheum. 2015 Oct;45(2):123-31. doi: 10.1016/j.semarthrit.2015.04.008. Epub 2015 Apr 10.

Authors

Yvonne M Golightly¹, Kelli D Allen², Kirsten A Nyrop³, Amanda E Nelson⁴, Leigh F Callahan⁵, Joanne M Jordan⁶

Affiliations

¹ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: [email protected].
² Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Health Services Research & Development, VA Medical Center, Durham, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
³ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Division of Hematology and Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁴ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁵ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
⁶ Thurston Arthritis Research Center, University of North Carolina at Chapel Hill, 3300 Thurston Building, CB #7280, Chapel Hill, NC 27599-7280; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Orthopaedics, University of North Carolina at Chapel Hill, Chapel Hill, NC.

PMID: 25979178
DOI: 10.1016/j.semarthrit.2015.04.008

Abstract

Purpose: Although many treatment guidelines exist for hip and knee osteoarthritis (OA), uptake in clinical practice is typically low. Valid patient-reported outcome measures (PROs) that can be easily used in the clinic could aid implementation and evaluation of treatment recommendations, and the tracking of symptoms and function over time. This project responded to a 2012 Call to Action of the Chronic Osteoarthritis Management Initiative of the United States Bone and Joint Initiative; we aimed to develop a tiered list of recommended PROs that could be feasibly applied in common clinical settings, across four domains of pain, function, fatigue, and sleep.

Methods: PROs were identified through a focused literature review. Clinicians and researchers with OA expertise evaluated each measure' feasibility for use in routine clinical practice, followed by meaningfulness in assessing OA outcomes. Eligible PROs were categorized by domain and ranked into Tiers One (very brief measures for initial use in clinical settings), Two (brief measures with more in-depth assessment), and Three (most detailed assessment).

Results: Total PROs identified were 172 for pain, 160 for function, 55 for fatigue, and 60 for sleep. Of these, 9 pain, 7 function, 7 fatigue, and 8 sleep PROs were ranked into one of three tiers.

Conclusions: This three-tiered list of recommended PROs provides a basis for tools to systematically track outcomes, facilitate provider-patient dialog, and guide treatment for hip or knee OA. Research is needed to test the utility and feasibility of systematic implementation of these measures in primary care and specialty clinical settings.

Keywords: Fatigue; Management; Osteoarthritis; Pain; Patient-reported outcomes; Physical function; Sleep.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Disease Management
Humans
Osteoarthritis, Hip / therapy*
Osteoarthritis, Knee / therapy*
Patient Outcome Assessment
Physician-Patient Relations
Primary Health Care