دورية أكاديمية
Functional Outcomes of a Musculoskeletal Integrated Practice Providing Comprehensive Whole Person Care for Hip Osteoarthritis.
| العنوان: | Functional Outcomes of a Musculoskeletal Integrated Practice Providing Comprehensive Whole Person Care for Hip Osteoarthritis. |
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| المؤلفون: | Jayakumar P; The University of Texas at Austin, Dell Medical School, Austin, TX., Galea VP; The University of Texas at Austin, Dell Medical School, Austin, TX; New York Medical College, School of Medicine, New York, NY., Geng M; The University of Texas at Austin, Dell Medical School, Austin, TX; Texas A&M University, Engineering Medicine Program, Houston, TX., Moore MG; The University of Texas at Austin, Dell Medical School, Austin, TX; Department of Plastic Surgery, University of South Florida, Tampa, FL., Bozic KJ; The University of Texas at Austin, Dell Medical School, Austin, TX., Koenig KM; The University of Texas at Austin, Dell Medical School, Austin, TX. |
| المصدر: | The Journal of arthroplasty [J Arthroplasty] 2022 Jul; Vol. 37 (7S), pp. S471-S478.e1. Date of Electronic Publication: 2022 Mar 12. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: Taylor and Francis Country of Publication: United States NLM ID: 8703515 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8406 (Electronic) Linking ISSN: 08835403 NLM ISO Abbreviation: J Arthroplasty Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New Brunswick, NJ : Taylor and Francis Original Publication: [New York, NY : Churchill Livingstone, c1986- |
| مواضيع طبية MeSH: | Osteoarthritis, Hip*/complications , Osteoarthritis, Hip*/surgery, Humans ; Minimal Clinically Important Difference ; Prospective Studies ; Retrospective Studies ; Treatment Outcome |
| مستخلص: | Background: Outcomes of hip osteoarthritis (OA) management within integrated practice units (IPUs) are lacking. This study reports 6-month and 1-year patient-reported outcomes (PROs) of IPU care, the proportion of patients achieving minimal clinically important difference (MCID) and substantial clinical benefit (SCB) at 1 year, and baseline factors associated with the likelihood of achieving MCID and SCB. Methods: We retrospectively evaluated 1009 new patients presenting to an IPU with hip OA between October 2017 and June 2020. Patients experienced multidisciplinary team-based management. Individuals with baseline and 6-month PROs or baseline and 1-year PROs (Hip Disability and Osteoarthritis Outcome Score Joint Replacement, HOOS JR) were included. We used anchor-based MCID and SCB thresholds and multivariable binary logistic regression models to identify baseline factors associated with achieving 1-year MCID and SCB. Results: HOOS JR increased from baseline to 6 months (Δ = 19.1 ± 2.1, P = .065) and baseline to 1 year (Δ = 35.8 ± 2.9, P < .001). At 1 year, 72.7% (IPU only) and 88% (IPU-based total hip arthroplasty [THA]) achieved MCID (P < .001), and 62.3% (IPU only) and 88% (IPU-based THA) achieved SCB (P < .001). In multivariable regression, lower baseline HOOS JR scores (r = 0.96, P = .04), undergoing THA (r = 0.213, P < .001), and fewer symptoms of generalized anxiety (r = 0.932, P = .018) were independently associated with achieving MCID at 1 year. The same factors were independently associated with achieving SCB at 1 year. Lower baseline anxiety (Generalized Anxiety Disorder Questionnaire-7 item) and greater hip-related preoperative limitations result in greater likelihood of achieving MCID and SCB. Conclusion: Significant improvements in patient outcomes can be achieved by IPUs providing comprehensive care for hip OA including the management of psychological distress. Future prospective studies should compare the outcomes of IPUs with traditional care in managing diverse patient phenotypes. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: biopsychosocial model; hip osteoarthritis; multidisciplinary team-based care; patient reported outcomes; value based health care |
| تواريخ الأحداث: | Date Created: 20220315 Date Completed: 20220608 Latest Revision: 20220728 |
| رمز التحديث: | 20221213 |
| DOI: | 10.1016/j.arth.2022.03.019 |
| PMID: | 35288247 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-8406 |
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| DOI: | 10.1016/j.arth.2022.03.019 |