title: Randomized trial of the effectiveness of a non-pharmacological multidisciplinary face-to-face treatment program on daily function compared to a telephone-based treatment program in patients with generalized osteoarthritis.
abstract: OBJECTIVE
  To compare the effectiveness of a non-pharmacological multidisciplinary face-to-face self-management treatment program with a telephone-based program on daily function in patients with generalized osteoarthritis (GOA).
  
  
  METHODS
  A pragmatic single-blind randomized clinical superiority trial involving 147 patients clinically diagnosed with GOA, randomly allocated to either a 6 week non-pharmacological multidisciplinary face-to-face treatment program comprising seven group sessions or a 6 week telephone-based treatment program comprising two group sessions combined with four telephone contacts. Both programs aimed to improve daily function and to enhance self-management to control the disease. The programs critically differed in mode of delivery and intensity. Daily function (primary outcome) and secondary outcomes were assessed at baseline, 6, 26 and 52 weeks. Data were analyzed using linear or logistic multilevel regression models corrected for baseline, sex and group-wise treatment.
  
  
  RESULTS
  No differences in effectiveness between both treatment programs were observed on the primary outcome (group difference (95% CI): -0.03 (-0.14, 0.07)) or on secondary outcome measures, except for a larger improvement in pain in the face-to-face treatment group (group difference (95% CI): 1.61 (0.01, 3.21)). Within groups, significant improvements were observed on several domains, especially in the face-to-face group. However, these benefits are relatively small and unlikely to be of clinical importance.
  
  
  CONCLUSIONS
  We found no differences in treatment effect between patients with GOA who followed a non-pharmacological multidisciplinary face-to-face self-management program and those who received a telephone-delivered program. Besides, our findings demonstrated limited benefits of a self-management program for individuals with GOA. Dutch Trial Register trial number: NTR2137.
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: n.cuperus@maartenskliniek.nl.
authors.forename: N
authors.initials: N
authors.lastname: Cuperus
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, CCTR Centre for Care Technology Research, Maastricht University, The Netherlands. Electronic address: thomashoogeboom@gmail.com.
authors.forename: T J
authors.initials: TJ
authors.lastname: Hoogeboom
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: c.kersten@maartenskliniek.nl.
authors.forename: C C
authors.initials: CC
authors.lastname: Kersten
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: a.denbroeder@maartenskliniek.nl.
authors.forename: A A
authors.initials: AA
authors.lastname: den Broeder
authors.affiliation: Department of Orthopaedics, Leiden University Medical Centre, Leiden, The Netherlands. Electronic address: t.p.m.vliet_vlieland@lumc.nl.
authors.forename: T P M Vliet
authors.initials: TP
authors.lastname: Vlieland
authors.affiliation: Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. Electronic address: e.vandenende@maartenskliniek.nl.
authors.forename: C H M
authors.initials: CH
authors.lastname: van den Ende
mesh_terms: D005081:Exercise Therapy; D005260:Female; D006801:Humans; D006875:Hydrotherapy; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000628:therapy*; D059408:Pain Management; D010348:Patient Care Team; D012648:Self Care; D016037:Single-Blind Method; D026302:Tai Ji; D017216:Telemedicine; D013689:Telephone; D064232:Visual Analog Scale
keywords: Generalized osteoarthritis; Non-pharmacological; Self-management