title: Pharmacist-initiated intervention trial in osteoarthritis: a multidisciplinary intervention for knee osteoarthritis.
abstract: OBJECTIVE
  Knee osteoarthritis (OA) is a commonly undiagnosed condition and care is often not provided. Pharmacists are uniquely placed for launching a multidisciplinary intervention for knee OA.
  
  
  METHODS
  We performed a cluster randomized controlled trial with pharmacies providing either intervention care or usual care (14 and 18 pharmacies, respectively). The intervention included a validated knee OA screening questionnaire, education, pain medication management, physiotherapy-guided exercise, and communication with the primary care physician. Usual care consisted of an educational pamphlet. The primary outcome was the pass rate on the Arthritis Foundation's quality indicators for OA. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Lower Extremity Function Scale (LEFS), the Paper Adaptive Test-5D (PAT-5D), and the Health Utilities Index Mark 3 (HUI3).
  
  
  RESULTS
  One hundred thirty-nine patients were assigned to the control (n = 66) and intervention (n = 73) groups. There were no differences between the groups in baseline measures. The overall quality indicator pass rate was significantly higher in the intervention arm compared to the control arm (difference of 45.2%; 95% confidence interval 34.5, 55.9). Significant improvements were observed for the intervention care group as compared to the usual care group in the WOMAC global, pain, and function scores at 3 and 6 months (all P < 0.01); the PAT-5D daily activity scores at 3 and 6 months (both P < 0.05); the PAT-5D pain scores at 6 months (P = 0.05); the HUI3 single-attribute pain scores at 3 and 6 months (all P < 0.05); and the LEFS scores at 6 months (P < 0.05).
  
  
  CONCLUSIONS
  Pharmacists can launch a multidisciplinary intervention to identify knee OA cases, improve the utilization of treatments, and improve function, pain, and quality of life.
authors.affiliation: University of British Columbia and Providence Health Care Research Institute, Vancouver, British Columbia, Canada. carlo.marra@ubc.ca
authors.forename: Carlo A
authors.initials: CA
authors.lastname: Marra
authors.forename: Jolanda
authors.initials: J
authors.lastname: Cibere
authors.forename: Maja
authors.initials: M
authors.lastname: Grubisic
authors.forename: Kelly A
authors.initials: KA
authors.lastname: Grindrod
authors.forename: Louise
authors.initials: L
authors.lastname: Gastonguay
authors.forename: Jamie M
authors.initials: JM
authors.lastname: Thomas
authors.forename: Patrick
authors.initials: P
authors.lastname: Embley
authors.forename: Lindsey
authors.initials: L
authors.lastname: Colley
authors.forename: Ross T
authors.initials: RT
authors.lastname: Tsuyuki
authors.forename: Karim M
authors.initials: KM
authors.lastname: Khan
authors.forename: John M
authors.initials: JM
authors.lastname: Esdaile
mesh_terms: D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D002170:Canada; D016000:Cluster Analysis; D003695:Delivery of Health Care / Q000379:methods; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000175:diagnosis* / Q000628:therapy; D059408:Pain Management; D010174:Pamphlets; D010348:Patient Care Team; D010353:Patient Education as Topic; D010595:Pharmacists; D058007:Physicians, Primary Care; D016896:Treatment Outcome
chemical_list: D000700:Analgesics