title: An innovative care model coordinated by a physical therapist and nurse practitioner for osteoarthritis of the hip and knee in specialist care: a prospective study.
abstract: The subject of the study is to investigate whether health-related quality of life (HRQoL), pain and function of patients with hip or knee osteoarthritis (OA) improves after a specialist care intervention coordinated by a physical therapist and a nurse practitioner (NP) and to assess satisfaction with this care at 12 weeks. This observational study included all consecutive patients with hip or knee OA referred to an outpatient orthopaedics clinic. The intervention consisted of a single, standardized visit (assessment and individually tailored management advice, to be executed in primary care) and a telephone follow-up, coordinated by a physical therapist and a NP, in cooperation with an orthopaedic surgeon. Assessments at baseline and 10 weeks thereafter included the short form-36 (SF-36), EuroQol 5D (EQ-5D), hip or knee disability and osteoarthritis outcome score (HOOS or KOOS), the intermittent and constant osteoarthritis pain questionnaire (ICOAP) for hip or knee and a multidimensional satisfaction questionnaire (23 items; 4 point scale). Eighty-seven patients (57 female), mean age 68 years (SD 10.9) were included, with follow-up data available in 63 patients (72 %). Statistically significant improvements were seen regarding the SF-36 physical summary component score, the EQ-5D, the ICOAP scores for hip and knee, the HOOS subscale sports and the KOOS subscales pain, symptoms and activities of daily living. The proportions of patients reporting to be satisfied ranged from 79 to 98 % per item. In patients with hip and knee OA pain, function and HRQoL improved significantly after a single-visit multidisciplinary OA management intervention in specialist care, with high patient satisfaction.
authors: Department of Medical Decision Making, Leiden University Medical Centre, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands. v.m.a.voorn@lumc.nl
authors: Veronique M A
authors: VM
authors: Voorn
authors: Henricus M
authors: HM
authors: Vermeulen
authors: Rob G H H
authors: RG
authors: Nelissen
authors: Margreet
authors: M
authors: Kloppenburg
authors: Tom W J
authors: TW
authors: Huizinga
authors: Nicolette A C
authors: NA
authors: Leijerzapf
authors: Herman M
authors: HM
authors: Kroon
authors: Thea P M
authors: TP
authors: Vliet Vlieland
authors: Henrica M J
authors: HM
authors: van der Linden
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000458:organization & administration; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004185:Disability Evaluation; D005260:Female; D006621:Hip Joint / Q000503:physiopathology; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009722:Nurse Practitioners / Q000458:organization & administration*; D015207:Osteoarthritis, Hip / Q000175:diagnosis / Q000451:nursing / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D020370:Osteoarthritis, Knee / Q000175:diagnosis / Q000451:nursing / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D010147:Pain Measurement; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D059825:Physical Therapists / Q000458:organization & administration*; D026741:Physical Therapy Modalities / Q000458:organization & administration*; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome