title: The effect of an educational program to improve health-related quality of life in patients with osteoarthritis on waiting list for total knee replacement: a randomized study.
abstract: OBJECTIVE
  To evaluate the effect of therapeutic education and functional readaptation (TEFR) on health-related quality of life (HRQL) in patients diagnosed with osteoarthritis on a waiting list for total knee replacement (TKR).
  
  
  METHODS
  Randomized controlled trial of 9 months duration was conducted. One hundred consecutive outpatients (71 females, mean age 71 years (range 50-86), mean disease duration 11.84+/-10.52 months) were included. Patients were randomized in two groups. The intervention group received TEFR added to conventional (pharmacological) treatment (n=51). The control group received conventional (pharmacological) treatment only (n=49). The main outcome variable was self-reported HRQL measured by the Spanish version of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes were general HRQL measured by Short Form Health Survey general questionnaire (SF-36), number of visits to general physicians and their cost. Assessments were done at baseline and at 9 months.
  
  
  RESULTS
  Eighty patients completed the study. Significant improvement in the WOMAC function was found at 9 months in the TERF group with respect to the control group (P=0.035). Consumption of analgesics increased significantly in the TERF group compared with controls (P=0.036). Significant improvements in pain (P=0.027) measured by WOMAC and in bodily pain (P=0.043) and physical function (P=0.031), measured by SF-36, were observed in the intervention group with respect to baseline.
  
  
  CONCLUSIONS
  The function dimension measured by WOMAC of patients who received both pharmacological treatment and TERF improved with respect to the control group receiving only pharmacological treatment. This suggests that a program of TEFR during the period on the waiting list for TKR may reduce the negative impact of this situation.
authors.affiliation: Orthopaedic Surgery Department, Hospital Clinic, Rheumatology, Villarroel 170, Barcelona, Spain. mnunez@clinic.ub.es
authors.forename: M
authors.initials: M
authors.lastname: Nuñez
authors.forename: E
authors.initials: E
authors.lastname: Nuñez
authors.forename: J M
authors.initials: JM
authors.lastname: Segur
authors.forename: F
authors.initials: F
authors.lastname: Macule
authors.forename: L
authors.initials: L
authors.lastname: Quinto
authors.forename: M V
authors.initials: MV
authors.lastname: Hernandez
authors.forename: C
authors.initials: C
authors.lastname: Vilalta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage; D019645:Arthroplasty, Replacement, Knee; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000534:rehabilitation* / Q000628:therapy; D010353:Patient Education as Topic / Q000379:methods*; D011788:Quality of Life; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014850:Waiting Lists
chemical_list: D000700:Analgesics