title: Can an intervention on clinical inertia have an impact on the perception of pain, functionality and quality of life in patients with hip and/or knee osteoarthritis? Results from a cluster randomised trial.
abstract: OBJECTIVE
  Evaluate whether an intervention applied to general practitioners to prevent clinical inertia had an impact on pain, functionality, and health-related quality of life (HRQoL) of patients with hip and/or knee osteoarthritis.
  
  
  METHODS
  This was a cluster-based, multicentre, prospective, randomized, parallel-group study. Clusters of physicians working were assigned to one of two study groups. Physicians in Group 1 received a training session while those in Group 2 did not.
  
  
  METHODS
  Primary Care Health centers representative of the entire Spanish territory.
  
  
  METHODS
  329 general practitioners of primary healthcare centre.
  
  
  METHODS
  The intervention consists of a motivational session to propose a proactive care, based on current recommendations.
  
  
  METHODS
  Visual analogue scale (VAS); functionality (WOMAC scale) and global perception of health by SF-12. Effects were measured in two visits six months apart.
  
  
  RESULTS
  A total of 1361 physicians, and 4076 patients participated in the study. No significant differences were observed in the clinical benefit obtained between patients assigned to Group 1 and Group 2. Nevertheless, a significant improvement was observed in the combined population (Groups 1 + 2) in the VAS (p<0.001), WOMAC (p<0.0001) and SF-12v2 (p<0.001) questionnaires in Visit 2 compared to Visit 1.
  
  
  CONCLUSIONS
  The results indicate that, although this specific intervention carried out on physicians did not provide an additional clinical benefit to patients with knee and/or hip osteoarthritis, an increased awareness of the patient's disease through the use of functionality indexes, as well as the mere fact of being observed, seem to improve patient-reported pain, functionality and HRQoL.
authors.affiliation: Medicina de Familia, Centro de Salud Las Ciudades, Madrid, Spain. atejedorv@telefonica.net
authors.forename: Alejandro
authors.initials: A
authors.lastname: Tejedor Varillas
authors.forename: Fernando
authors.initials: F
authors.lastname: León Vázquez
authors.forename: David
authors.initials: D
authors.lastname: Lora Pablos
authors.forename: Alvaro
authors.initials: A
authors.lastname: Pérez Martín
authors.forename: Francisco
authors.initials: F
authors.lastname: Vargas Negrín
authors.forename: Agustín
authors.initials: A
authors.lastname: Gómez de la Cámara
mesh_terms: D000368:Aged; D001294:Attitude to Health; D016000:Cluster Analysis; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D015207:Osteoarthritis, Hip / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010146:Pain / Q000209:etiology; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D011788:Quality of Life