The web-based osteoarthritis management resource my joint pain improves quality of care: A quasi-experimental study

Background: despite the availability of evidence-based guidelines for conservative treatment of osteoarthritis (oa),management is often confined to the use of analgesics and waiting for eventual total joint replacement. this suggests a gap in knowledge for persons with oa regarding the many different treatments available to them. objective: our objective was to evaluate outcomes after usage of a web-based resource called my joint pain that contains tailored,evidence-based information and tools aimed to improve self-management of oa on self-management and change in knowledge. methods: a quasi-experimental design was used to evaluate the my joint pain website intervention over a 12-month period. the intervention provided participants with general and user-specific information,monthly assessments with validated instruments,and progress-tracking tools. a nationwide convenience sample of 195 participants with self-assessed hip and/or knee oa completed both baseline and 12-month questionnaires (users: n=104; nonusers: n=91). the primary outcome measure was the health evaluation impact questionnaire (heiq) to evaluate 8 different domains (health-directed activity,positive and active engagement in life,emotional distress,self-monitoring and insight,constructive attitudes and approaches,skill and technique acquisition,social integration and support,health service navigation) and the secondary outcome measure was the 17-item osteoarthritis quality indicator (oaqi) questionnaire to evaluate the change in appropriateness of care received by participants. independent t tests were used to compare changes between groups for the heiq and chi-square tests to identify changes within and between groups from baseline to 12 months for each oaqi item. results: baseline demographics between groups were similar for gender (152/195,77.9% female),age (mean 60,sd 9 years) and body mass index (mean 31.1,sd 6.8 kg/m2). with the exception of health service navigation,mean effect sizes from all other heiq domains showed a positive trend for my joint pain users compared to the nonusers,although the differences between groups did not reach statistical significance. within-group changes also showed improvements among the users of the my joint pain website for self-management (absolute change score=15%,p=.03),lifestyle (absolute change score=16%,p=.02),and physical activity (absolute change score=11%,p=.04),with no significant improvements for the nonusers. following 12 months of exposure to the website,there were significant improvements for users compared to nonusers in self-management (absolute change score 15% vs 2%,p=.001) and weight reduction (absolute change scores 3% vs -6%,p=.03) measured on the oaqi. conclusions: the my joint pain web resource does not significantly improve overall heiq,but does improve other important aspects of quality of care in people with hip and/or knee oa. further work is required to improve engagement with the website and the quality of information delivered in order to provide a greater impact. ©hema umapathy,kim bennell,chris dickson,fiona dobson,marlene fransen,graeme jones,david j hunter.